小隐静脉动脉化为血供的复合瓣重建腕部电烧伤手功能

目的　腕部电烧伤的手功能重建 ,多需进行长段的肌腱、神经移植。但局部组织移植受床条件差的问题需克服。方法　我们设计了包含小隐静脉、腓肠神经和小腿筋膜的复合组织瓣 ,在静脉动脉化修复患肢血管 ,带血供移植神经的同时 ,利用筋膜瓣重建组织移植受床 ,并在此筋膜瓣上进行长段肌腱移植。结果　本组共 6例 ,5例成功 ,1例失败。随访 5～ 18个月感觉恢复分别达S2 ～S3,屈指活动 ,距掌横纹距分别达 1 5～ 5 2cm。结论　该术式术后肌腱粘连较轻 ,缩短了电击伤手功能重建的治疗周期 ,提高了疗效。

Functional reconstruction of the hand after electrical injury with a composite flap of the vessel nerve and fascia]

OBJECTIVE: In the case of electrical injury of the wrist, it may be necessary to transplant a long tendon, nerve and vessel for functional reconstruction. But the fibrosis of the recipient bed often makes the survival and functioning of the grafts difficult. This clinical study was to solve the problem. METHODS: A composite flap was designed consisting of the small saphenous vein, the sural nerve and the fascia of the lower-leg. The small saphenous vein and the nerve were transplanted to repair the defects of the radial or ulnar artery and the media nerve. The fascia was used to reconstruct the recipient bed for tendon grafting. RESULTS: Six cases were treated with this method with success in 5 cases. 5 to 18 months' follow-up revealed restoration of sensation and finger flexion in the 5 cases. CONCLUSION: This method is effective in alleviating tendon adhesion, accelerating functional restoration of the injured hand.