游离第2趾胫侧皮瓣结合压力治疗修复指腹缺损

目的探讨应用游离第2趾胫侧皮辫结合压力治疗修复及指腹缺祯的临床疗效。方法对10例14指指腹软组织缺损，应用游离第2趾胫侧皮瓣修复。皮肤缺损面积最大约4．0cm×1．5cm，最小约1．5cm×1．0cm．平均约2．5cm×1．2cm。切取第2趾胫侧皮瓣面积最大约4．5cm×2．2cm，最小约2．0cm×1．5cm。术后2周，修复指佩带压力套接受24h压力治疗3个月。结果术后皮瓣全部成活，随访3～15个月，平均9个月。修复指腹肤色红润，质地良好。皮瓣与原手指皮肤交界处过渡自然，瘢痕不明显，修复指腹外形接近正常手指。指腹温暖，无畏寒。修复指腹2-PD8～15mm，平均11mm。足部供区一期愈合，无瘢痕挛缩等并发症。所有患者步态正常，无足部疼痛或行走不适感。小腿供区一期愈合。结论应用游离第2趾胫侧皮瓣结合压力治疗修复手指指腹缺损，不仅可以较好地恢复指腹的感觉和功能，而且可使外形接近正常手指，是修复此类损伤的理想方法。

Repair soft tissue defect of the finger pulp by using tibial flap of the second toe with pressure therapy

Objective To discuss the treatment effect of repairing finger pulp soft tissue defect by using tibial flap of the second toe with pressure therapy. Methods 10 patients 14 fingers with finger pulp soft tissue defects of were treated by the second toe tibial skin flap. The sizes of soft tissue defect varied from 1.5cm×1.0cm to 4.0cm×1.5cm （mean, 2.5m×l.2cm）. The sizes of skin flap varied from 2.0cm×1.5cm to 4.5 cm×2.2 cm （mean, 2.0 cm×1.5 cm）. 2 weeks after operation, the repaired finger began to wear the pressure suit during the whole day and then lasted 3 months. Results All flaps survived. Patients were followed for 3-15 months with an average of 9 months. The color and texture of the repaired finger pulp was good, and the appearance of pulp was similar to the contralateral finger. Fingertip was warmth, without cold intolerance. 2-PD of the pulp was from 8 mm to 15 mm （mean, 11 mm）. The donor sites of the flaps healed well. Conclusion It is an ideal method for repairing soft tissue defects of the finger pulp by using tibial flap of the second toe with pressure therapy. The method can restore the blood supply and sensory of the injured finger, and reconstruct the appearance, which is similar to the contralateral finger.