缝合神经的掌骨背逆行筋膜蒂皮瓣修复逆行指动脉皮瓣术后供区皮肤缺损

目的：探讨采用缝合神经的掌骨背逆行筋膜蒂皮瓣修复逆行指动脉皮瓣切取后指神经裸露及软组织缺损的方法及疗效。方法应用缝合神经的掌骨背逆行筋膜蒂皮瓣修复逆行指动脉皮瓣移植后供区软组织缺损20例21指，软组织缺损面积：1.5 cm×2.0 cm～2.0 cm×3.0 cm。随访检测患指皮瓣外观、关节活动度及感觉等指标。结果术后20例皮瓣全部成活。术后经5个月随访，修复后患指指动脉皮瓣供区外形饱满，质地柔软，局部皮肤感觉及供区各关节活动范围令人满意。结论采用缝合神经的掌骨背逆行筋膜蒂皮瓣修复逆行指动脉皮瓣切取后供区指神经裸露及软组织缺损是有效而简单的方法，并可获得良好的外形及功能。

Use the dorsal metacarpal artery reverse fascial flap with nerve anastomosis to repair the donor site after repairing fingertip defects with the reversed pedicle digital artery island flap

Objective To use the dorsal metacarpal artery reverse fascial flap with nerve anastomosis to cover the donor site and the naked digital nerve after repairing fingertip defects with the reverse pedicle digital artery island flap. Methods Use the dorsal metacarpal artery reverse fascial flap with nerve anastomosis to repair the donor site and naked digital nerve after repairing fingertip defects with the reverse digital artery island flap was performed in 20 patients （21 digits）, the area of soft issue defects was about 1.5 cm×2.0 cm～2.0 cm×3.0 cm in size. Postoperatively the appearance of the flap, joint movement and sensation were evaluated. Results All the flaps survived. The finger contour, range of motion and the recover of sensation were evaluated at five months postoperative follow-up, were satisfactory. Conclusion The method of using the dorsal metacarpal artery reverse fascial flap with nerve anastomosis to repair the donor site after repairing fingertip defects with the reverse digital artery island flap is simple and efficient, which can achieve good cosmetic and functional results.