前臂背桡侧穿支皮瓣游离移植修复手指软组织缺损

目的 报告前臂背桡侧穿支皮瓣的手术方法和临床疗效.方法 设计前臂背桡侧穿支皮瓣游离移植,修复手指皮肤软组织缺损,临床应用17例20指.结果 20块皮瓣全部存活.12例获得3～12个月的随访,5例失访.皮瓣外观不臃肿;修复指背者,皮瓣色泽接近受区,但修复指腹者皮瓣色泽与受区有差异.修复指腹并缝合指神经者9例10指.其中获得9～12个月随访者6例,皮瓣感觉恢复均达S3,两点分辨觉为8～12mm .所有供区创面均直接缝合,仅遗留线状瘢痕.结论 前臂背桡侧穿支皮瓣血管人皮点恒定,血管蒂口径能满足吻合的要求.修复手指外观满意,通过缝合指神经能恢复良好感觉.

Free radiodorsal forearm perforator flap transfer in the treatment of soft tissue defect of the finger

Objective To introduce the surgical techniques and clinical results of radiodorsal forearm perforator flap. Methods Radiodorsal forearm perforator flap was designed and harvested for free transfer to cover soft tissue defect of the fingers. A total of 20 flaps were applied clinically in 20 fingers of 17 cases.Results All 20 flaps survived. Twelve cases were followed for 3 to 12 months. Five cases were lost for follow up. The flaps were thin. The color of the flaps was closed to that of the recipient sites in dorsal finger defects.But there was a difference in color when the flap was used to cover palmar finger defects. The flap was employed to reconstruct finger pulp with digital nerve coaptation in 10 fingers of 9 cases. Among those 6 cases were followed up for 9 to 12 months. Sensation of the flaps recovered to S3. Two-point discrimination was 8 to 12 mm. All the donor site wound were closed primarily. Only linear scar was left. Conclusion Radiodorsal forearm perforator flap has a constant perforator. The calibre of the vascular pedide is big enough for anastomosis. The fingers repaired with this flap had a good shape and satisfactory sensory recovery can be achieved by nerve coaptation.