改良第四掌背动脉逆行岛状皮瓣的临床应用

目的：探讨用改良的第四掌背动脉逆行岛状皮瓣修复手指软组织缺损的临床效果。方法：对16例新鲜肢体作血管灌注造影，发现掌背动脉指背支与指动脉背侧支在近节指背中段相吻合。设计以指固有动脉背侧支为蒂的第四掌背动脉逆行岛状皮瓣修复环，小指软组织缺损13例。供区均直接缝合。结果：13例皮瓣全部成活。术后随访3个月至1年，皮瓣质地；厚度良好。结论：该皮瓣血供可靠，切取方便，旋转弧度较长，适用于修复环、小指末节软组织缺损。

The clinical application of modified fourth dorsal metacarpal artery reversed is land flap

Objective To report the treatment outcome of the modified fourth dorsal metacarpal artery reversed island flap for repair of soft tissue defect at the finger. Methods Angiography was done in the fresh extremity for 16 cases .The digital dorsal branches of the dorsal metacarpal artery and the dorsal branches of the digital artery were communicated at the proximal,dorsal and middle part of phalange. Soft tissue defect at the ring and small finger was repaired by the fourth dorsal metacarpal artery reversed island flap pedicled with the dorsal branch of digital artery in 13 cases. The donor area was sutured directly. Results The flap was survived in 13 cases. The appearance was satisfactory over a period of follow up between 3 months and 1 year. Conclusions The flap is reliable in blood supply and convenient dissection, especially with greater rotating arc of the flap. It can be suitable for reconstruction of the distal soft tissue defect at the ring and little fingers.