含皮神经的前臂骨间背侧动脉带蒂皮瓣修复虎口挛缩畸形

目的:探讨含皮神经的改良前臂骨间背侧动脉带蒂皮瓣修复虎口挛缩的手术方式及临床疗效。方法:我科自2015年1月至2019年5月收治31例虎口中重度挛缩患者，彻底松解虎口挛缩后，以尺骨茎突上1.5～2.5 cm处为旋转点，根据虎口处软组织缺损面积设计含皮神经的改良前臂骨间背侧动脉带蒂皮瓣逆行转移。软组织缺损面积为4 cm×...

Application of antebrachial dorsal interosseous artery pedicled flap containing cutaneous nerve for repair of thumb web contracture

Objective To investigate the surgical method and clinical effect o￡modified antebrachial dorsal interosseous artery pedicled flap containing cutaneous nerve for repair of thumb web contracture.Methods From January 2015 to May 2019,31 patients with moderate to severe thumb web contracture were treated.After the contracture was completely released,the modified antebrachial dorsal interosseous artery pedicled flap with cutaneous nerve was designed according to the soft tissue defect area,and 1.5 to 2.5 cm above the ulna styloid process was used as the rotation point.The area of soft tissue defect was 4 cm×2 cm to 15 cm×6 cm,and the area of flap was 5 cm×2 cm to 16 cm×6 cm.The donor site was repaired by direct suture or free skin grafting.Results All the patients were follow-up for 6 to 24 months with an average of 14 months.The skin flap had no obvious pigmentation with good elasticity and beautiful appearance.The thumb web contracture was corrected.The functions of thumb opposition,abduction and adduction were improved.The wrist function was normal.According to the evaluation standard of upper limb function of Hand Surgery Society of Chinese Medical Association,12 cases were excellent,17 cases were good and 2 cases were fair.The protective sensation was restored to S2 to S3.Only skin graft scar was left in donor site.Conclusion The modified antebrachial dorsal interosseous artery pedicled flap with cutaneous nerve is an ideal method to repair the soft tissue defect caused by thumb web contracture.