带掌长肌腱的游离腕横纹皮瓣修复手指复合组织缺损

目的探讨带掌长肌腱的腕横纹游离皮瓣在手指复合组织缺损中的应用及疗效。方法 2015年1月至2017年1月,7例手指复合组织缺损患者,通过急诊或择期手术,采用同侧带掌长肌腱的游离腕横纹皮瓣修复创面,皮瓣根据需要可携带正中神经掌皮支,供区创面直接拉拢缝合。结果 7例皮瓣均成活,供区创面一期愈合。术后随访6～12个月,皮瓣色泽好,无臃肿,质地柔软,静止两点辨别觉为3～5 mm;按照中华医学会手外科学会上肢部分功能评定试用标准,本组中手指功能优6例,良1例,优良率100%。结论本方法可一次性修复患指创面和肌腱缺损,重建患指运动及感觉功能,且皮瓣外形、质地较好,是目前修复手指复合组织缺损较好的方法。

Wrist Transverse Free Flap with Palmaris Longus Tendon in the Repair of Finger Complex Tissue Defect

Objective To explore the effect of wrist transverse free flap with palmaris longus tendon in the repair of finger complex tissue defect. Methods From January 2015 to January 2017, a total of 7 cases with composite tissue defects of fingers were concluded in this retrospective study. The finger complex tissue defect was repaired by free wrist transverse flaps with palmaris longus tendon and palmar cutaneous branch of the median nerve in emergency or in secondary stage. The incision of donor sites was closed primarily. Results All flaps were survived. The wounds of the donor site healed by first intention. The patients were followed up for 6 -12 months, the flap was soft with good color and no significant flap bloated appearance, and the static two point discrimination was 3 -5 mm. According to the upper extremity functional evaluation criteria of the Chinese Medical Association of Hand Surgery, 6 cases were excellent, 1 case was good, and the excellent and good rate was 100R. Conclusion This method can not only repair skin and tendon defects in one stage, but also reconstruct the motion and sensory function of the fingers. It can offer good appearance and skin texture, which is recommended to repair finger composite tissue defects.