拇指指腹缺损的显微外科修复

目的 探讨含感觉神经的微型皮瓣修复拇指指腹缺损的临床疗效.方法 2000年2月-2010年3月,采用食指背岛状皮瓣、中指侧方岛状皮瓣、以桡侧指动脉为蒂逆行岛状皮瓣、桡动脉掌浅支为蒂的逆行皮瓣、拇指尺背侧动脉逆行皮瓣、拇指背皮神经营养血管皮瓣、第2趾趾腹皮瓣、？？趾甲皮瓣、大鱼际部浅静脉动脉化逆行皮瓣共9种皮瓣修复重建拇指指腹缺损134例.结果 3例皮瓣坏死,131例成活,6个月～1.5年随访108例,皮瓣外形血供充分,质地柔软,感觉测定S2～S4＋,两点辫别觉6～11mm.结论 采用含感觉神经的微型皮瓣修复拇指指腹缺损,对供区影响小、效果佳、为理想的术式选择.

Microsurgical reconstruction of the thumb pulp defect

Objective To investigate the result of repairing the pulp defects of thumb by several small flaps which contain sensitive nerves. Methods From February 2000 to March 2010, We repaired the thumb pulp defect in 134 cases with nine types of flaps. Nine kinds of flaps were the dorsal island flap of the index finger,the neurovascular island flap of the ring finger,the radial artery as the pedicle of the fingers retergrate island flap,superficial palmar branch of radial artery pedide flap,dorsal ulnar artery flap thumb, thumb dorsal neurocutaneous flap,the second toe plamtar flap, the coraparoand toe flap and department of saperficial thenar of the retrograde veno-arteriohzation flap. Results 3 cases of skin flap necrosis,131 cases of flap survival.108 cases were followed up fron 6 months to 18 months,good shape and full blood supply were obtained,and the determination was S2-S4＋, the sensation with 2-PD of 6-11mm. Conclusion It is an ideal method of the small flaps which contain senstive for construction of pulp defects of the thumb,and the donor site morbidity is minimal.