用V—Y皮瓣和游离指（趾）甲修复指端损伤

１９８５年以来，用Ｖ－Ｙ皮瓣和游离指（趾）甲修复指端损伤８例１４指，全部成活。用原指甲修复１２指，切取趾甲修复指端损伤２指。随访６个月￣５年，指端外形与正常相似，指端皮肤痛、温、触觉恢复正常。有指甲的指端在捏持小的针类物体时较灵活，稳定。手术方法易于掌握，成活率高，对指端软组织缺损者为一良好修复方法。     

推进皮瓣和游离指（趾）甲移植修复指端损伤

指甲损伤机会较多,1983年 Sait 报道指甲损伤治疗效果极好,恢复指甲的外形和功能有临床意义。无指甲在捏持小的物体时有困难。推进皮瓣内含有神经和血管,其指端痛、温、触觉正常。我们自1985年以来应用推进皮瓣和游离指(趾)甲移植修复指端损伤8例17指,获得良好效果,报道如下。     

游离(足母)趾背和第二趾背甲皮瓣修复指甲缺损的临床应用

目的报道游离拇趾背和第二趾背甲皮瓣修复指甲缺损的临床疗效。方法对41例43指指甲缺损的患者，应用拇趾背、第二趾背甲皮瓣进行修复，并对疗效进行分析。结果移植后的指甲全部成活，术后随访4个月-3年，平均25个月，1指皮瓣稍显臃肿，予二期手术修整。全部移植指甲生长均良好，指端触觉恢复满意，手指远侧指间关节活动度接近正常，可以抓捏细小物体。参照Zook指甲修复标准评定：优40指，良3指，优良率达100％。足部供区植皮愈合良好，足功能无明显影响。结论应用拇趾背、第二趾背甲皮瓣修复指甲缺损，可以最大限度地恢复手指外形及功能，对供区损伤小，是手指指甲缺损修复的理想方法。     

指侧方皮下组织蒂V—Y皮瓣重建指端缺损

介绍指侧方皮下组织蒂Ｖ－Ｙ皮瓣重建指端的手术方法及临床效果。方法：将Ｖ－Ｙ皮瓣重建指端的手术方法及临床效果方法：将Ｖ－Ｙ推进皮瓣的组织蒂设计在皮瓣的侧方，从而增加该皮瓣的推进距离，用于修复长度在２．０ｃｍ范围内的指端创面。１９８８年以来，临床应用２２例，指端创面长度最短为１．０ｃｍ，最长为２．０ｃｍ。结果：皮瓣全部成活。     

V—Y皮瓣加甲皱襞U形切除甲床扩大成形术修复指端缺损

目的探讨“V—Y”皮瓣联合甲床扩大成形术修复指端缺损的疗效。方法应用“V—Y”皮瓣及甲皱襞“u”形切除甲床扩大成形术治疗指端缺损32例。结果皮瓣全部成活，甲床有效扩大并具有健指正常的外形和功能。结论该术式操作简单、安全、损伤小，是修复指端缺损的有效方法。     

游离指部微型皮瓣修复指端软组织缺损

拇指、２～５指指端皮肤缺损，常用各种岛状皮瓣或局部转移皮瓣修复。但如因局部或邻近组织同时损伤，则难以应用这两类皮瓣治疗。１９９６年１月至今，我们应用吻合血管的手指侧方游离皮瓣修复指端皮肤缺损５例，取得较为满意的疗效。一、应用解剖指掌侧总动脉来自手部掌...     

M-W皮瓣在指(趾)蹼重建中的临床应用

目的：介绍一种指（趾）蹼重建的新方法。方法：对34例先天性并指（趾）和外伤性并指患者，分别于并指（趾）背和手掌，足底侧设计“M”和“∧”皮瓣，术后形成M－W皮瓣重建指（趾）蹼，结果：术后皮 瓣全部成活，指（趾）蹼外形接近正常，术后随访1－3年，34例的分指（趾），屈指（趾）功能良好，结论：该术式重建的指（趾）蹼较传统的三角瓣，矩形瓣等法有更好的外形和功能。     

带血管和神经的双侧V—Y皮瓣修复指端缺损

目的 探讨双侧V-Y皮瓣推进修复指端缺损的临床效果.方法 以指动脉、神经为蒂的双侧V-Y皮瓣推进修复指端缺损56例63指,其中食指25指,中指26指,环指12指.结果 修复手指全部成活,随访3～14个月,按TAM法评定优良率达95%.结论 该手术操作简便安全,术后效果满意,是修复指端缺损的理想方法.     

桥接指动脉神经的游离第二趾胫侧皮瓣修复手指侧方软组织缺损

目的 探讨手指侧方软组织伴有指固有动脉、神经缺损的修复方法和疗效.方法 对8例手指中近节侧方软组织并伴有一侧指固有动脉和神经缺损的患者,应用桥接指动脉神经的游离第二趾胫侧皮瓣修复手指侧方软组织缺损.缺损面积为4.0 cm× 1.5 cm～ 2.0 cm× 1.0 cm,切取皮瓣面积为4.2 cm× 1.8 cm～2.5 cm× 1.5 cm,指固有动脉、神经缺损1.0～4.0 cm,平均2.4 cm.结果 术后皮瓣全部存活,随访时间为6～ 36个月,平均15个月.修复指体外形好,指端温暖,无怕冷现象.指体Allen试验阴性,修复侧指端两点分辨觉6～15 mm,平均8mm.供区创面愈合好.结论 应用桥接指固有动脉、神经的第二趾胫侧皮瓣修复手指侧方软组织缺损,可以较好地恢复手指的外形、血供及感觉,是修复此类损伤较为理想的方法.     

指动脉逆行岛状皮瓣修复指端损伤

指端的创伤缺损十分常见,修复方法很多,用指动脉逆行岛状皮瓣转移修复是一种可选择的方法。但皮瓣内不含皮神经,移位至指尖以后,感觉恢复常不满意。若要采用这种指术方式,供皮区最好在示、中指尺侧,环、小指桡侧设计。     

指动脉顺行岛状皮瓣修复指端缺损

目的 探讨指动脉顺行岛状皮瓣修复指端缺损的临床效果.方法 2005年12月至2008年10月,采用指动脉顺行岛状皮瓣修复63例72指指端软组织缺损,最大面积为21 mm×27mm,最小为8 mm×11 mm.结果 63例72指皮瓣全部成活,术后随访4～19个月,功能及外观效果满意,两点辨别觉7～9 mm,平均8 mm,手功能TAM法测定:优59指,良11指,可2指.结论 该手术方法操作简便、安全,是修复指端缺损较为理想的方法.     

指动脉顺行岛状皮瓣修复指端缺损

Objective To investigate the therapeutic effect of island flaps pedieled with digital artery for the defects at the end of fingers. Methods 63 eases with 72 soft tissue defects at the end of fingers were treated with the island flaps. The flap size ranged from 8 mm× 11 mm to 21 nun × 27 ram. Results All the flaps survived completely. The follow-up period ranged from 4 to 19 months. The functional and cosmetic results were satisfactory. The two-point discrimination was 7 ～ 9 mm. The TAM functional examination showed excellent in 59 fingers, good in 11 fingers and common in 2 fingers. Conclusions The technique with island flap is simple and reliable for the defects at the end of fingers.     

指动脉顺行岛状皮瓣修复指端缺损

Objective To investigate the therapeutic effect of island flaps pedieled with digital artery for the defects at the end of fingers. Methods 63 eases with 72 soft tissue defects at the end of fingers were treated with the island flaps. The flap size ranged from 8 mm× 11 mm to 21 nun × 27 ram. Results All the flaps survived completely. The follow-up period ranged from 4 to 19 months. The functional and cosmetic results were satisfactory. The two-point discrimination was 7 ～ 9 mm. The TAM functional examination showed excellent in 59 fingers, good in 11 fingers and common in 2 fingers. Conclusions The technique with island flap is simple and reliable for the defects at the end of fingers.     

指动脉顺行岛状皮瓣修复指端缺损

Objective To investigate the therapeutic effect of island flaps pedieled with digital artery for the defects at the end of fingers. Methods 63 eases with 72 soft tissue defects at the end of fingers were treated with the island flaps. The flap size ranged from 8 mm× 11 mm to 21 nun × 27 ram. Results All the flaps survived completely. The follow-up period ranged from 4 to 19 months. The functional and cosmetic results were satisfactory. The two-point discrimination was 7 ～ 9 mm. The TAM functional examination showed excellent in 59 fingers, good in 11 fingers and common in 2 fingers. Conclusions The technique with island flap is simple and reliable for the defects at the end of fingers.     

指动脉顺行岛状皮瓣修复指端缺损

Objective To investigate the therapeutic effect of island flaps pedieled with digital artery for the defects at the end of fingers. Methods 63 eases with 72 soft tissue defects at the end of fingers were treated with the island flaps. The flap size ranged from 8 mm× 11 mm to 21 nun × 27 ram. Results All the flaps survived completely. The follow-up period ranged from 4 to 19 months. The functional and cosmetic results were satisfactory. The two-point discrimination was 7 ～ 9 mm. The TAM functional examination showed excellent in 59 fingers, good in 11 fingers and common in 2 fingers. Conclusions The technique with island flap is simple and reliable for the defects at the end of fingers.     

指动脉顺行岛状皮瓣修复指端缺损

Objective To investigate the therapeutic effect of island flaps pedieled with digital artery for the defects at the end of fingers. Methods 63 eases with 72 soft tissue defects at the end of fingers were treated with the island flaps. The flap size ranged from 8 mm× 11 mm to 21 nun × 27 ram. Results All the flaps survived completely. The follow-up period ranged from 4 to 19 months. The functional and cosmetic results were satisfactory. The two-point discrimination was 7 ～ 9 mm. The TAM functional examination showed excellent in 59 fingers, good in 11 fingers and common in 2 fingers. Conclusions The technique with island flap is simple and reliable for the defects at the end of fingers.     

指动脉顺行岛状皮瓣修复指端缺损

Objective To investigate the therapeutic effect of island flaps pedieled with digital artery for the defects at the end of fingers. Methods 63 eases with 72 soft tissue defects at the end of fingers were treated with the island flaps. The flap size ranged from 8 mm× 11 mm to 21 nun × 27 ram. Results All the flaps survived completely. The follow-up period ranged from 4 to 19 months. The functional and cosmetic results were satisfactory. The two-point discrimination was 7 ～ 9 mm. The TAM functional examination showed excellent in 59 fingers, good in 11 fingers and common in 2 fingers. Conclusions The technique with island flap is simple and reliable for the defects at the end of fingers.     

指动脉顺行岛状皮瓣修复指端缺损

Objective To investigate the therapeutic effect of island flaps pedieled with digital artery for the defects at the end of fingers. Methods 63 eases with 72 soft tissue defects at the end of fingers were treated with the island flaps. The flap size ranged from 8 mm× 11 mm to 21 nun × 27 ram. Results All the flaps survived completely. The follow-up period ranged from 4 to 19 months. The functional and cosmetic results were satisfactory. The two-point discrimination was 7 ～ 9 mm. The TAM functional examination showed excellent in 59 fingers, good in 11 fingers and common in 2 fingers. Conclusions The technique with island flap is simple and reliable for the defects at the end of fingers.     

指动脉顺行岛状皮瓣修复指端缺损

Objective To investigate the therapeutic effect of island flaps pedieled with digital artery for the defects at the end of fingers. Methods 63 eases with 72 soft tissue defects at the end of fingers were treated with the island flaps. The flap size ranged from 8 mm× 11 mm to 21 nun × 27 ram. Results All the flaps survived completely. The follow-up period ranged from 4 to 19 months. The functional and cosmetic results were satisfactory. The two-point discrimination was 7 ～ 9 mm. The TAM functional examination showed excellent in 59 fingers, good in 11 fingers and common in 2 fingers. Conclusions The technique with island flap is simple and reliable for the defects at the end of fingers.     

指动脉顺行岛状皮瓣修复指端缺损

Objective To investigate the therapeutic effect of island flaps pedieled with digital artery for the defects at the end of fingers. Methods 63 eases with 72 soft tissue defects at the end of fingers were treated with the island flaps. The flap size ranged from 8 mm× 11 mm to 21 nun × 27 ram. Results All the flaps survived completely. The follow-up period ranged from 4 to 19 months. The functional and cosmetic results were satisfactory. The two-point discrimination was 7 ～ 9 mm. The TAM functional examination showed excellent in 59 fingers, good in 11 fingers and common in 2 fingers. Conclusions The technique with island flap is simple and reliable for the defects at the end of fingers.