拇指桡背侧筋膜蒂皮瓣修复甲床缺损

目的 探讨拇指桡背侧筋膜蒂皮瓣修复甲床缺损的临床疗效.方法 2010年3月~2012年10月,对拇指甲床损伤采用桡背侧筋膜蒂皮瓣急诊修复8例,延期修复4例.以拇指背侧指间关节及掌指关节中点连线和拇指桡侧中线之间的中线为轴心线,在拇指桡背侧设计皮瓣,切取皮瓣面积2.0 cm×1.8 cm～3.0 cm×2.5 cm.结果 12例皮瓣均成活,其中2例出现静脉危像,经及时处理症状消失.术后随访3～10 个月,拇指外形良好,皮瓣质地软,不臃肿,类似指甲;其中进行了神经吻合的皮瓣两点分辨觉6～10 mm.按中华医学会手外科分会标准评定,手功能达优10例、良2例.结论 应用拇指桡背侧筋膜蒂皮瓣修复甲床缺损,手术成功率高、操作简单、疗效肯定,建议临床推广.

Nail Bed Defect Repaired by Thumb Radial Dorsal Fasciocutaneous Flap

Objective To investigate thumb dorsal radial fasciocutaneous front sarcolemma flap treat and the clinical efficacy for the treatment of nail bed defect. Methods Since March 2010 to October 2012, of the patients with the thumb nail bed injury using radial dorsal fascia flaps emergency repair eight cases, four cases of delayed repair . Dorsal thumb interphalangeal joints and metacarpophalangeal joints and thumb radial midpoint between the center line, the centerline between the two lines as the axis, the thumb radial dorsal flap designed, cut the flap size 2.0 cm ~ 1.8 cm ~ 3.0 cmx 2.5 cm. Results 12 cases flaps survived, including 2 cases of venous crisis, after timely treatment all survived. Patients were followed up from 3 to 10 months, the thumb in good shape, flap soft texture, not bloated, similar to the nail; wherein the flap nerve anastomosis performed point discrimination 6 ~ l0 ram, according to the Chinese Medical Association of Hand Surgery Branch upper part of the functionassessment of hand function assessed trial standards were excellent in 10 cases, good in 2 cases. Conclusion Thumb radial dorsal fasciocutaneous treatment of nail bed defect is surgical success rate, simple operation, and suitable for clinical practice.