带蒂髂腹股沟骨皮瓣在急性复杂手外伤中的应用

目的:介绍带蒂髂腹股沟骨皮瓣在急性复杂手外伤中应用的适应证及手术方法。方法:自2000年以来,应用带蒂髂腹股沟骨皮瓣并吸收积水潭医院手外科腹部分层组织瓣手术方法,对合并骨、肌腱、神经损伤缺损等急性复杂手外伤进行一期修复,共实施手术18例。结果:18例患者经过4～26个月(平均8.9个月)随访,患者皮瓣愈合良好,骨质愈合。采用手-前臂手术疗效评价表,平均分数达74.6分。结论:带蒂髂腹股沟骨皮瓣在急性手外伤手术修复中具有广泛的适应证。该手术的优点是在提供的局部皮肤覆盖的同时,修复掌、指骨缺损,也为损伤的肌腱、神经修复、愈合提供良好的软组织条件。

Clinical application of the pedical iliogroin in repairing complicated hand injury

Objective:To introduce the method,indications and the usage of the pedical iliogroin for the emergency treatment of complicated hand injury.Methods:The pedical iliogroin flap was designed to repair the complicated hand injury with bone nonunion,tendon and nerve defect after we learned the abdominal double-layer subcutaneous flap of Department of Hand Surgery of Beijing Jishuitan Hospital.Eighteen cases were treated with this method since 2000.Results:The duration of the follow-up ranged from 4 to 26 months with an average of 8.9 months.All of the flaps survived well,and the defect was cured completely.After physiotherapy,the patient outcomes of Surgery-Hand/Arm(POS-Hand/Arm) was used.Patients after suryery got average marks of 74.6.Conclusion:The pedical iliogroin featured extensive indication in those cases with complicated hand injury.This kind of flap provided a good skin covering,repaired metacarpal and phalanx bone defect and offered a soft bed for the tendons and nerves.