改良食指背侧岛状皮瓣及其感觉训练的临床研究

目的关于食指背侧岛状皮瓣改良术式临床修复拇指软组织缺损或瘢痕挛缩及皮瓣异位感觉康复训练的临床研究。方法2006年2月至2007年12月，对12例拇指软组织缺损患者利用改良的食指背侧岛状皮瓣方法修复拇指创面。术后鼓励患者做患指康复训练，拆线后指导患者加强拇指康复训练，特别加强改善皮瓣异位感觉的康复训练。结果所有皮瓣均成活。本组病例随访4-6月，患者拇指皮瓣外形好，拇指掌指关节及指间关节活动在正常范围，皮瓣血运良好，皮瓣感觉正常，皮瓣异位感觉康复训练后的感觉恢复需要约4个月，而未经过康复训练的皮瓣异位感觉恢复要晚2个月左右。结论临床上修复拇指软组织缺损，无论食指背桡侧动脉为三型中的哪一种分型，通过改良食指背侧岛状皮瓣切取修复，均能保证皮瓣一期成活，经康复训练，使拇指皮瓣异位感觉提前2个月恢复。

The clinical research of reforming posterior island flap of index-finger and aesthesia rehabilitation training of the flap dystopia

Objective Clinical research of modified posterior indices island flap in repair of the damage and the scar contracture of the thumb parenchyma and the therapeutic effect of the aesthesia rehabilitation training of flap dystopia.Metbods During February of 2006 till December of 2007, we had repaired 12 cases of the thumb with the way of modified posterior indices island flap of index finger.After the operation,we encouraged the patients to do the aesthesia rehabilitation training,after taking out the stitches,we conducted the patients to strengthen the rehabilitation training of the thumb,especially strengthen the rehabilitation training of the flap dystopia aesthesia. Results All the flaps survived. We made the follow-up from 4 up to 6 months, the shape of the thumb flaps of the patients looked fine,the joint connects the fingers and the palm and the joints connect the parts of the fingers could get the normal reach, the circulation of the flaps worked well, the of the flaps was fine, it took 4 months of the rehabilitation training of flap dystopia to get the recovered, but without it, it took 2 moths more. Conclusion To repair the damage of parenchyma of the thumb in clinical trail, regardless which type the arteria radialis belongs to, through the incisional biopsy and repaired of reforming posterior indices islet-shape＇s flap, we can assure that the flaps survive in the first period, after the aesthesia rehabilitation training, we can advance the time of the aesthesia of flap dystopia of the thumb to two months.