掌背动脉筋膜瓣修复手指背侧组织缺损

目的 报道应用带掌背动脉的筋膜瓣加游离植皮修复手指背侧组织缺损的临床疗效.方法 2003年12月-2009年12月共治疗手指背侧组织缺损36例,根据手指指背软组织缺损情况,分别采用了顺行带掌背动脉筋膜瓣（10例）、逆行带掌背动脉筋膜瓣（20例）和U-I型掌背动脉筋膜瓣（6例）进行修复.筋膜瓣面积：1.2cm×2.1cm～2.5cm×4.5cm.结果 36例筋膜瓣加植皮区全部成活,术后随访1～12个月,平均6个月,其中31例外形和功能恢复较为满意（86 %）,5例不满意（14%）.结论 选用带掌背动脉筋膜瓣加游离植皮修复手指背侧组织缺损,具有手术操作相对简便,对供区影响小,外形良好,不损伤指固有动脉及神经等优点,可一、二期修复手指背侧不同部位的皮肤缺损.

Repair of the soft tissue defects in dorsal fingers using the dorsal metacarpal artery-based fascial flaps

Objective To report the use of the dorsal metacarpal artery-based fascial flaps and skin graft for repairing the soft tissue defects of the dorsal fingers. Methods From December 2003 to December 2009, 36 cases with soft tissue defects of the dorsal fingers were treated by using the dorsal metacarpal arterybased fascial flap （n=10）, reverse dorsal metacarpal artery-based fascial flap （n=20）, and the dorsal hand U-I flap （n=6）. The flap size ranged from 1.2cm×2.1cm to 2.5cm×4.5cm. Results All flaps survived completely. Follow-up ranged from 1 to 12 months with an average of 6 months. We obtained satisfactory and unsatisfactory results in 31 and 5 cases, including appearance, color, texture, and function. Conclusion The combination of the dorsal metacarpal artery-based Fascial flaps and skin graft is useful for repairing the dorsal soft tissue defects of the fingers.