Structural bone allografts with intramedullary vascularized fibular autografts for the treatment of massive bone defects in extremities

Objective：To report the clinical outcome of repairing massive bone defects biologically in limbs by homeochronous using structural bone allografts with intramedullary vascularized fibular autografts. Methods： From January 2001 to December 2005, large bone defects in 19 patients （11 men and 8 women, aged 6 to 35 years） were repaired by structural bone allografts with intramedullary vascularized fibular autografts in the homeochronous period. The range of the length of bone defects was 11 to 25 cm （mean 17.6 cm）, length of vascularized free fibular was 15 to 29 cm （mean 19.2 cm）, length of massive bone allografts was 11 to 24 cm （mean 17.1 cm）. Location of massive bone defects was in humerus（n=1）, in femur（n=9） and in tibia（n=9）, respectively. Results： After 9 to 69 months （mean 38.2 months） follow-up, wounds of donor and recipient sites were healed inⅠstage, monitoring-flaps were alive, eject reaction of massive bone allografts were slight, no complications in donor limbs. Fifteen patients had the evidence of radiographic union 3 to 6 months after surgery, 3 cases united 8 months later, and the remained one case of malignant synovioma in distal femur recurred and amputated the leg 2.5 months, postoperatively. Five patients had been removed internal fixation, complete bone unions were found one year postoperatively. None of massive bone allografts were absorbed or collapsed at last follow-up. Conclusion： The homeochronous usage of structural bone allograft with an intramedullary vascularized fibular autograft can biologically obtain a structure with the immediate mechanical strength of the allograft, a potential result of revascularization through the vascularized fibula, and accelerate bone union not only between fibular autograft and the host but also between massive bone allograft and the host.     

阴囊皮瓣结合阴茎延长术修复阴茎部分缺损

目的 评价阴囊皮瓣结合阴茎延长术修复阴茎缺损的可行性和临床效果.方法 1999至2008年对7例阴茎缺损患者(年龄19～42岁)采用阴囊皮瓣结合阴茎延长术进行修复.患者术前常态残端阴茎长1.0～3.0 cm,平均2.1 cm;勃起时阴攀长3.0～5.5 cm,平均4.8 cm.先采用阴茎海绵体延长术使阴茎充分延伸,再用阴囊前动脉为蒂的双侧阴囊皮瓣(3例)或整块阴囊前壁皮瓣(4例)转位覆盖延伸的阴茎海绵体创面.阴囊切口直接缝合.结果 本术式无需重建尿道,阴囊皮瓣切取方便,手术时间短(3～4 h),操作简单,术中出血少(30～50 ml,平均40 ml).7例患者切口均一期愈合,阴囊皮瓣血运良好,重建的阴茎外观满意.术后随访1～5年,阴茎常态下长5.0～7.5 cm,平均6.4 cm;阴茎勃起时长8.0～10.5 cm,平均9.5 cm;排尿、勃起及射精功能均正常.5例自述性生活满意,1例可以完成性生活.结论 采用阴囊皮瓣修复阴茎部分缺损的方法简便而有效,术后阴茎有可以接受的外观和长度,同时具有更好的感觉和勃起功能.     

5·12汶川地震中皮肤软组织缺损伤的特点和治疗

目的 探讨5· 12汶川地震所致皮肤软组织缺损伤的特点和治疗方法.方法 2008年5月12口至6月7日,收治地震所致皮肤软组织缺损伤员37例43处创面.其中男20例,女17例;年龄2～85岁,平均40岁;部位:头部2处,躯干3处,上臂5处,前臂5处,大腿13处,小腿15处;范围:5 cm ×4 cm ～27 cm ×20 cm.19例(51.3％)伤员创面分泌物细菌培养阳性.创面经彻底清创后,对症治疗并湿敷换药,待感染控制、新鲜肉芽组织生长良好后,41处行皮片、2处行局部皮瓣移植修复.观察皮片或皮瓣存活率,评估手术治疗效果.结果 所有伤员分别于入院6～15d后行皮片或局部皮瓣移植术修复创面,术后皮片存活好,皮瓣血供佳,其中皮瓣完全存活2处,95％以上面积皮片存活33处,90％以上面积皮片存活8处.伤员住院时间12 ～23 d,无严重全身性感染及死亡病例.结论 地震伤所致皮肤软组织缺损多见于肢体及头部,污染重,局部感染发生率高.早期清创及对症治疗,适时行皮片、皮瓣修复术,有助于其及早愈合.     

三面会师法切取胫后动脉高位穿支蒂皮瓣修复小腿中下段骨外露

目的总结胫后动脉高位穿支蒂皮瓣修复小腿中下段软组织缺损的方法及临床疗效。方法 2008年9月～2011年5月,我科共收治25例小腿中下段软组织缺损伴骨外露患者。男19例,女6例,年龄15～61岁,平均36岁。软组织缺损范围2cm×3cm～7cm×14cm;创面采用胫后动脉高位穿支蒂皮瓣修复,供区直接缝合或植皮修复。皮瓣面积为3cm×5cm～9cm×18cm,病程7天至2月。结果术后25例皮瓣全部成活,骨外露创面及供区Ⅰ期愈合。其中2例因切取平面达腘窝平面上2cm,术后皮瓣远端约2cm×3cm表皮青紫,经换药拆线松解蒂部后皮瓣完全存活,18例患者获随访,随访时间6～33月,平均18月。皮瓣色泽、质地及外形良好。随访病例6月后皮瓣恢复保护性感觉。结论胫后动脉高位穿支供血皮瓣血供可靠,操作简便,不损伤肢体主要动脉,供区损害小,是修复小腿中下段软组织缺损的良好皮瓣。     

Ilizarov技术治疗胫骨感染性骨缺损

目的 探讨应用Ilizarov技术治疗胫骨感染性骨缺损的临床疗效.方法 2008年1月-2012年12月,我科采用Ilizarov技术治疗胫骨感染性骨缺损患者315例,男性236例,女性79例;年龄14 ～ 72岁,平均35岁;病史2个月～10年,平均9个月.病变在胫骨上段86例,胫骨中段92例,胫骨下段137例;伴有软组织缺损146例.骨缺损长度2～ 18cm,平均8cm;随访时间1～6年,平均28个月.术后随访观察骨及软组织愈合及并发症情况.结果 315例感染均一期控制,未见骨髓炎复发,软组织缺损创面全部愈合.63例行胫骨短缩延长术患者均实现一期骨性愈合.252例行胫骨骨搬移术,147例骨断端一期骨性愈合;97例骨断端经二期植入髂骨松质骨后实现骨性愈合;8例骨延长区成骨不良,经髂骨植骨后全部愈合.8例出现足下垂畸形,15例出现钉道感染,2例拆除外固定架后出现再骨折,10例出现轴向偏移,上述患者经对症处理后均得到良好疗效.结论 对于胫骨感染性骨缺损患者,Ilizarov技术能同时实现感染病灶彻底清除、骨不连治疗、皮肤软组织修复以及均衡肢体长度,一期手术达到满意的治疗效果.     

肱骨近端肿瘤异体骨关节移植重建术的疗效及远期并发症

目的 回顾分析采用单纯大段异体骨关节移植治疗肱骨近端肿瘤、重建骨缺损的疗效及远期并发症,评估这一重建方式的可行性.方法 回顾分析2001年11月至2008年11月手术治疗后并获得随访的7例肱骨近端肿瘤患者的临床资料.其中男6例,女1例;年龄21～65岁,平均38.4岁.肿瘤类型:骨巨细胞瘤5例,骨肉瘤1例,恶性纤维组织细胞瘤1例.全部7例患者均行瘤段切除、大段异体骨关节移植、髓内钉内固定重建术治疗.结果 随访时间2～8年,平均5.5年.7例均于术后随访时发现植骨萎缩吸收,此现象一般于术后 1.5年出现,6年内移植骨几乎完全吸收.依据肌肉骨骼肿瘤协会功能评估系统,关节移植病例评分为15～19分,平均17.6分(满意度58.6%);根据肌肉骨骼肿瘤协会关于异体骨移植放射线评估标准,远期优良率为0.结论 在肱骨近端的异体骨关节移植,移植骨萎缩吸收是一种主要的远期并发症,发生率高;单纯大段异体骨关节移植在肱骨近端的骨缺损重建被认为是一种不可行的方法.

Abstract：

Objective To analyze the functional efficacies and complications for the reconstruction of defects in proximal humerus tumors with massive osteoarticular allograft transplantation and evaluate the feasibility of this method. Methods A retrospective review was performed for proximal humerus tumors surgically treated and followed up from November 2001 to November 2008. There were 6 males and 1 female with an average age of 38.4 years old (range :21 -65 ). The tumor characteristics were as follows: giant cell tumor ( n = 5 ), osteosarcoma ( n = 1 ) and malignant fibrous tissue tumor ( n = 1 ). According to the Enneking classification system, there were Ⅰ A (n = 5), Ⅱ A (n = 1 ) and Ⅱ B ( n = 1 ). All patients were reconstructed with massive osteoarticular allograft transplantation and immobilized with interlocking nail. The average length of massive allograft was 15. 2 cm ( range: 11 - 19). Results All patients were followed up for an average of 5. 5 years (range: 2- 8). In a long-term follow-up, atrophy and adsorption of allograft were found in all cases without clinical symptoms. This phenomenon started to appear after 1.5 years. And bone graft disappeared completely in around 6 years postoperatively. The atrophy of bone graft usually originated from greater tubercles and extended gradually to metaphysic. According to the Musculosketetal Tumor Society (MSTS) functional classification system, the average score of osteoarticular allografts was 17.6 (range: 15 -19). According to the MSTS radiological evaluation system, the long-term perfect/fair rate was 0. Conclusion Massive osteoarticular allograft transplantation is one of feasible options for the reconstruction of structural bone defects due to bone tumor resection.     

脱钙骨修复骨肿瘤术后骨缺损115例

目的探讨脱钙骨治疗骨肿瘤术后骨缺损的疗效。方法应用脱钙骨充填治疗骨肿瘤术后骨缺损115例,男72例,女43例;年龄5～65岁,平均34岁。结果全部病例均获随访,随访时间l～8年,平均4年2个月。满意106例,占92.2%;不满意9例,占7.8%。结论脱钙骨修复骨肿瘤术后骨缺损组织相容性好,方法简便,疗效肯定,是理想的植骨材料。     

腭部环状骨移植在上前牙区种植修复中的应用

目的：探讨腭部环状骨移植在上前牙区骨量不足患者中的应用,并对其临床效果进行评价。方法选取我院2008年12月—2010年12月完成的腭部环状骨移植后种植修复病例12例,其中单颗牙缺失9例,2颗牙缺失3例,共植入种植体15颗,通过测量垂直向和水平向增加骨量评价腭部环状骨移植后的临床效果。结果创口均一期愈合,6．5个月后垂直向骨高度增加（2.3±0.9）㎜,水平向骨宽度增加（2.6±0.9）mm ,垂直向及水平向骨吸收率分别为8.4％和9.3％,种植体留存率100％。结论腭部环状骨移植是解决种植修复中上前牙区骨量不足的有效方法。     

游离背阔肌皮瓣移植修复上肢皮肤软组织缺损

目的探讨游离背阔肌皮瓣移植修复上肢皮肤软组织缺损的临床效果。方法 2005年7月～2009年8月,采用游离背阔肌皮瓣移植修复上肢皮肤软组织缺损创面16例。其中挤压伤6例,热压伤5例,机器绞轧脱套伤2例,电伤击伤1例,爆炸伤1例,蛇咬伤1例。均合并骨,肌腱外露,合并骨折7例,合并关节开放感染6例。合并血管神经损伤4例,5例伴屈、伸肘功能障碍。皮肤软组织缺损缺损面积6cm×13cm～15cm×32cm;切取背阔肌皮瓣7cm×14cm～16cm×35cm,供区均以中厚皮片移植修复。结果 16例背阔肌皮瓣全部成活,创面愈合满意。术后获随访2～31个月,其中5例皮瓣外形臃肿,二期行皮瓣修薄整形术;重建感觉的5例患者3例恢复保护性感觉。3例以背阔肌作动力重建屈、伸肘关节功能部分恢复。3例供区植皮部分坏死,其中2例经换药后治愈,l例二期植皮修复,余供区植皮均成活。结论背阔肌皮瓣血运丰富,具有很强的抗感染能力。且切取面积大,并同时以背阔肌可作动力重建屈、伸肘关节功能。是修复上肢皮肤软组织缺损和骨外露感染创面的较为理想皮瓣之一。     

颅底内外沟通性肿瘤的手术治疗

前、中颅底内外沟通性肿瘤22例,均经CT和脑血管造影确诊,手术全切除17例,次全切除5例,无手术死亡。随访4个月～3年,显效9例,进步4例,改善4例,恶化2例。作者强调手术应根据肿瘤所侵袭的范围和蔓延方向采用不同的入路,以充分显露,尽可能全切除肿瘤。生物粘合剂和明胶海绵对修补硬脑膜以及重建颅底有效。     

带蒂颞筋膜瓣结合游离皮片移植眼眶再造术

目的报道应用带蒂颞筋膜瓣转移结合游离皮片移植进行眼眶再造的临床体会。方法对17例因外伤及肿瘤术后等造成的眼窝重度凹陷、结膜囊重度狭窄或眼窝闭锁、义眼无法安放患者,采用带颞浅血管蒂颞浅筋膜瓣转移结合游离植皮进行眼眶再造,筋膜瓣3cm×4cm～8cm×10cm大小,其中外伤致眶内容摘除术后9例,视网膜母细胞瘤术后5例,眼睑黑色素瘤眶内容物摘除术一期修复3例。结果该组颞浅筋膜瓣全部成活,皮片成活后外形平坦无血肿及感染等并发症,经随访6～60个月,再造的眼窝外形满意。其中2例皮片部分坏死,1例补充植皮后愈合,1例换药后自愈;2例因肿瘤复发并远处转移病故,但眼部外形正常。结论带蒂颞浅筋膜瓣血运丰富,易成活,结合皮片移植手术方法简单、创伤小、术后外形好,是眼眶再造的较好选择。     

Initial experience with lingual mucosal graft urethroplasty for anterior urethral strictures

Background

To present the feasibility of lingual mucosal graft urethroplasty in anterior urethral strictures and appraisal of donor site morbidity.

Methods

From November 2007 to December 2010, 14 patients underwent dorsal onlay lingual mucosal graft urethroplasty for anterior urethral strictures. Lingual mucosal graft was harvested from the lateral and undersurface of the tongue. Check micturating cystourethrograms were done 2 weeks after catheter removal and uroflowmetry after 3 months. Success was defined as normal uroflowmetry rates at 3 months in the absence of any postoperative instrumentation. Tongue was assessed for any residual pain, taste disturbances or restricted movement at 3 months.

Results

Four patients had submucosal fibrosis of the oral cavity and their buccal mucosa was unfit for grafting. Mean (range) stricture length was 5 (3–16) cm and the operation time 170 (140–210) min. Graft width averaged 1.6 cm. Average length of harvested graft was 6.5 cm. Mean duration of follow-up was 12.8 months. Two patients developed stricture at the proximal anastomotic site. There were no donor site complications.

Conclusions

Lingual mucosal graft harvesting is simple, gives graft lengths comparable to buccal mucosa and is associated with negligible donor site morbidity.     

完全电视胸腔镜下肺叶切除的临床体会

目的:探讨完全电视胸腔镜肺叶切除的安全性及可靠性。方法:2012年9月²013年8月,我科共施行全胸腔镜肺叶切除10例,男7例,女3例;年龄402013年8月,我科共施行全胸腔镜肺叶切除10例,男7例,女3例;年龄40⁷3岁。腋后线第九肋间稍偏后作为观察孔;腋前线及腋中线之间第四肋间473岁。腋后线第九肋间稍偏后作为观察孔;腋前线及腋中线之间第四肋间4⁵ cm切口,作为主操作孔;腋前线第七肋间作为副操作孔。施行解剖性肺叶切除,其中右上肺3例、右中肺1例、右下肺2例、左上肺1例、左下肺3例。结果:全组病人均顺利完成手术,无中转开胸,无围手术期死亡。手术时间1055 cm切口,作为主操作孔;腋前线第七肋间作为副操作孔。施行解剖性肺叶切除,其中右上肺3例、右中肺1例、右下肺2例、左上肺1例、左下肺3例。结果:全组病人均顺利完成手术,无中转开胸,无围手术期死亡。手术时间105²40 min;术中出血量40240 min;术中出血量40²10 ml;清扫淋巴结4210 ml;清扫淋巴结4¹2枚;胸腔引流管放置时间312枚;胸腔引流管放置时间3¹0 d;术后住院时间810 d;术后住院时间8¹4 d。术后出现肺部感染1例,房颤1例,经积极治疗后痊愈。全组病人随访314 d。术后出现肺部感染1例,房颤1例,经积极治疗后痊愈。全组病人随访3¹4个月无复发。结论:完全电视胸腔镜肺叶切除术是一种安全、有效、更加微创的术式。     

Biomechanical study of human dura and its substitutes

目的：测试与分析人硬脑膜及其替代物的生物力学特性,为选择理想的颅度缺损重建材料提供依据。方法：通过生物力学试验测定人硬脑膜及其替代物的蠕变特性,通过动物实验测定狗颅骨缺损区硬脑膜生物力学特性的动态变化。结果：人体硬脑膜的蠕变特征为：初始应变和所加的应力大体成线性关系;蠕变应变随时间缓慢增加,表示人体硬脑膜及其替代材料蠕变特性的柔度公式的一般形式为：J(t)=J0 Kf(t)。颅底缺损区硬脑膜初始应变的动态变化是：术后1个月减少约35％,术后3个月减少约为46％,术后6个月减少约为50％。结论：可用蠕变柔度测试判断颅底骨缺损硬脑膜修补材料的优劣,柔度愈小,抗膨出性能愈好。新鲜人硬脑膜的柔度最小,冻干人硬脑膜、新鲜人颅骨膜、硅橡胶膜、涤纶片的柔度依次壮大。颅底缺损区硬脑膜蠕变减少的程度随时间延长而逐渐增加,术后1-3月减少明显,3-6月变化趋缓。     

感染性骨不连伴大段骨缺损的治疗

目的 探讨颗粒状松质骨移植治疗感染性骨不连伴大段骨缺损的效果.方法 对19例(20个部位)感染性骨不连伴大段骨缺损患者进行清创、外固定、颗粒状松质骨移植方法 治疗,其中自体骨移植14例(15个部位),异体骨移植5例.结果 平均随访32.7个月(20～56个月).5例异体骨移植患者均无感染复发,其中3例获得骨愈合,外固定指数是(2.22±0.84)个月/cm;2例发生骨不连,再次手术取自体松质骨植骨获得骨愈合.14例(15个部位)自体骨移植患者,2例(2个部位,13.3%)感染复发导致植入骨吸收骨不连,接受再次清创自体骨移植获得骨连接、感染消灭;12例(13个部位,86.7%)骨愈合患者,外固定指数是(1.96±0.74)个月/cm.共3例(4个部位)发生再骨折,分别接受石膏固定、外固定支架及内固定获得骨愈合.结论感染性骨不连伴大段骨缺损采用自体颗粒状松质骨移植是合适的;异体骨移植骨不连发生率高、外固定时间长,应慎用.     

山羊胫骨大段骨缺损的组织工程骨修复及放射性核素显像监测

目的探讨组织工程骨对山羊大段骨缺损的修复能力及放射性核素骨显像技术在此过程中的监测效果。方法将27只中国青山羊,分为组织工程骨组、人工骨组和对照组(每组9只)并分别造成左侧胫骨2cm骨缺损。对组织工程骨组缺损区植入珊瑚羟基磷灰石(CHAP)和骨髓基质干细胞(BMSc)复合体,人工骨组植入CHAP,对照组则不植入任何填充物。采用放射性核素骨显像于术后2、4、8周监测各组骨修复情况。结果通过放射性核素骨显像测定的感兴趣区(ROI)计数和T/NT比值显示:对照组在各时间点均未见再血管化的表现及明显的成骨活动;人工骨组随着时间的延长其血管再生的数量和成骨的质量呈现出上升的趋势;组织工程骨组上升趋势更为显著。结论组织工程骨较人工骨具有更佳的修复大动物大段骨缺损的能力,放射性核素骨显像在修复过程中有比较准确的预测效果。     

残余空间隔缺损的再手术治疗12例

目的 分析残余室间隔缺损（VSD）的发生原因、防治措施、手术指征和手术要点。方法 对12例施行残余VSD再手术治疗患者的发生原因、预防措施、手术指征和手术要点进行分析。结果 12例中8例首次手术于1977年至1997年在我院施行,4例在外院施行,我院VSD再手术率为0.18%。首次手术时单纯VSD 9例,法洛四联症（TOF）3例。再次手术间期平均4.1年（5个月～12年）。再次手术发现10例VSD再通部位均在三类瓣前隔瓣基底附近,残余VSD长径平均1.2cm(0.3～2.5cm）。手术死亡3例,死亡原因包括低心排、心律失常和心包填塞。结论 1.VSD再通好发于三尖瓣前隔瓣基底邻近,这与该区域邻近主动脉瓣和传导束等重要而结构复杂、可利用缝合的坚固组织少、三尖瓣叶和腱索的遮挡造成VSD的边缘暴露不清等因素有关。2.预防VSD再通关键在于充分暴露VSD边缘,防止漏缝和撕裂。3.0.5cm以上的残余VSD应尽早手术。4.再次手术以右房切口和补片修补为佳,术终止血要严密。     

前路单枚螺钉治疗老年齿状突Anderson Ⅱ型骨折的疗效观察

目的：探讨颈前路单枚中空螺钉内固定技术治疗老年齿状突AndersonⅡ型骨折临床疗效。方法：对23例齿状突AndersonⅡ型骨折老年患者在透视下行颈前路单枚螺钉内固定术,所有患者术前行颅骨牵引复位,术中植入单枚螺钉,术后颈托外固定。结果：术后随访6～23个月,2例于最后随访仍未达到骨性愈合,5例于术后3个月复查骨折已达骨性愈合,10例于术后5个月复查时显示骨性愈合,6例于术后1 a复查骨性愈合。结论：前路单枚螺钉内固定治疗老年AndersonⅡ型齿状突骨折具有良好的稳定性,保留了寰枢关节运动功能,骨折愈合率较高,并发症低。     

Free peroneal perforator-based sural neurofasciocutaneous flaps for reconstruction of hand and forearm

Background Sural neurofasciocutaneous flap has been popularly used as an excellent option for the coverage of soft tissue defects in the lower third of leg, ankle and foot, but its free transplantation has been rarely reported. The objective of our work was to investigate the operative technique and clinical results of repairing the soft tissue defects of hand and forearm with free peroneal perforator-based sural neurofasciocutaneous flap. Methods Between May 2006 and March 2007, 10 patients including 7 men and 3 women were treated. Their ages ranged from 22 to 51 years. They presented to emergency with large soft tissue defects of 16 cm × 7 cm to 24 cm × 10 cm in size in hand and forearm after injured by motor vehicle accidents （2 cases） or crushed by machine （8 cases）. Thorough debridements and primary treatments to associated tendon ruptures or bone fractures were performed on emergency. And free peroneal perforator-based sural neurofasciocutaneous flaps were transplanted when the wound areas were stable at 5 to 7 days after emergency treatment. The flaps were designed along the axis of the sural nerve according to the shape and size of the soft tissue defects, with the peroneal perforator above the lateral malleolus as the pedicle and along with a part of the peroneal artery for vascular anastomosis. Then the flaps were harvested to repair the recipient sites with the peroneal artery anastomosed to the radial （or ulnar） artery and the peroneal veins to one of the radial （or ulnar） veins and the cephalic vein respectively. The flap sizes ranged from 18 cm × 8 cm to 25 cm × 12 cm. The donor areas were closed by skin grafts. Results All of the 10 flaps survived after surgeries. Marginal necrosis occurred in only 2 cases. The skin grafts survived entirely in the donor sites, and no obvious influence on the donor legs was observed. All of the transplanted flaps presented favourable contours and good functions at 9 to 12 months＇ follow-up. Conclusions Peroneal perforator-based sural neurofasciocutaneous flap has favourable appearance, constant vascular pedicle, reliable blood supply, large size of elevation, and minimal influence on the donor site. The free transplantation of this flap offers a satisfactory alternative for repairing the large soft tissue defects of forearm and hand.     

同指螺旋皮瓣修复指端指腹缺损的疗效报告

目的：研究同指螺旋皮瓣修复指端指腹缺损的临床疗效。方法：回顾性分析2010年1月~2012年9月在江门市人民医院骨科行同指螺旋皮瓣修复指端指腹缺损手术的患者资料，共22例27指。采用拍照和问卷调查的方式来评估术后情况。评价指标包括伤口愈合及美观程度评价，手指功能恢复情况，重返工作岗位的时间，关节运动情况，两点辨别觉等。结果：男性16例（72.7％），女性6例（27.3％）。年龄（33.4±13.1）岁。皮瓣及移植皮片全部存活（成功率为100％），无需要二次手术的患者，无皮瓣充血、血肿、感染等围手术期并发症。缺损面积最大为2.5 cm×3 cm，最小为1.0 cm×1.5 cm，均伴有骨、肌腱外露。术后应用抗生素（3.5±2.8） d。随访时间（22.5±10.3）月。患者回到原工作岗位时间（6.9±2.3）周。感觉功能恢复好，两点辨别觉平均值为6.3 mm（5~7 mm）。没有一例出现不耐寒冷和超敏反应。结论：同指螺旋皮瓣修复指端指腹缺损临床疗效好，患者满意，适应在临床上广泛推广。