急诊游离[母]趾腓侧皮瓣修复指腹缺损

目的报道应用母]趾腓侧皮瓣急诊游离移植修复手指腹侧软组织缺损的临床效果。方法以母]趾腓侧趾底血管、神经为蒂的腓侧皮瓣游离移植手指腹侧软组织缺损25例。趾供区直接缝合18例，游离皮片植皮7例，皮瓣切取面积最大为5．0cm×3．0cm，最小为2．0cm×1．5cm。结果25例游离移植皮瓣全部成活，均未发生血管危象及伤口感染，伤口一期愈合。随访时间3月－2年，移植指腹皮瓣随时间增长，感觉恢复逐渐接近正常，无明显瘢痕形成，外观完好，皮纹清晰，两点分辨觉在4—6mm，伤指对捏、持物时无疼痛及感觉过敏，指功能恢复正常。母]趾供区愈合良好，无疼痛性瘢痕及胼胝形成，活动功能无影响。结论应用母]趾腓侧皮瓣急诊游离移植修复指腹侧软组织缺损方法可靠，临床治疗效果好，值得应用推广。

Emergency repair of pulp defect by free grafting hallux latero-fibula flap

Objective To report the clinical effects of the hallux latero-fibula flap emergency free grafting in repairing the ventralis soft tissue defect of fingers.Methods The hallux latero-fibula flap pedicled with plantar matatars blood vessel and nerve free repaired the 25 cases with the pulp defect of fingers.18 cases could be surtured directly with the hallux latero-fibula flap and 7 cases could be repaired by grafting with free skin.The maximum area of flap was 5.0cm×3.0cm and the minimum was 2.0cm×1.5cm.Results All free skin flap of 25 cases survived successfully with no blood vessel articulo and wound infection.The wounds were primary healing.The Follow-up time was from 3 months to 24 months.The feeling of the free pulp of fingers flap is approached to normal gradually.Well-tended appearance and clear skin lines and no visible cicatrix. Both point tactile sensation was at 4-6mm.The injury fingers can pinch and hold but no pains and hyperaesthesia.The function of injury fingers recoveried normaUy.The wound of the hallux donor area heals well with no visible scar and callositasand the motor function were not effected.Conclusion Clinical application of the hallux latero-fibula flap emergency free grafting in repairing the pulp defect of fingers is an ideal treatmentand with good clinical effects. It is worth to applicating wildly in clinic.