指背筋膜逆行岛状皮瓣修复指腹缺损

目的 介绍指背筋膜逆行皮瓣修复指腹、指尖缺损的手术方法及临床效果。方法 在手指近节中远段及近侧指间关节背倒设计皮瓣，皮瓣边缘不超过手指侧正中线，轴点位于远侧指间关节背桡侧或尺背侧，指背侧缘为轴心线。切取的皮瓣内含有指固有神经背侧支，转移后与创面指固有神经断端缝合。结果 本组16例皮瓣全部成活，随访5～18个月，外形美观，质地柔软、耐磨，指腹两点辨别觉为4mm—7．5mm。供区无并发症发生。结论 该皮瓣具有不损伤主要动脉、神经，操作简便，质地良好，血供可靠等优点，重建的指腹感觉恢复满意，是修复指腹缺损的较好方法。

Repair of finger pulp defects with reverse dorsal digital island fascial flap

Objective To introduce a method for repair of finger pulp defect with reverse dorsal digital island fascial flap.Methods Based on the features of blood supply of the dorsal skin of finger,the flap was designed at the middle and distal segments on the proximal phalanx and the dorsum of the proximal interphalangeal joint.The lateral margins of the flap did not cross the midlateral line.The axial point was designed on the ulnar or radial dorsum of the distal interphalangeal joint,and the axis was at the lateral margin line of dorsum.The dorsal branch of proper digital nerve in the flap was sutured to the end of the proper digital nerve of injured site.Results All flaps survived completely in16cases.They were followed up from8to18months,with an average of 11months.The pulp of finger after reconstruction had good appearance and sensation(with4mm-7.5mm of 2-PD).Conclusion The operation doesn,t damage the proper digital artery and nerve of the injured finger.The flap is a reliable flap with easy dissection and good fexture in repair of finger pulp defects.The sensation of the reconstructed pulp can be satisfactorily recovered.