吻合神经的尺神经手背支营养血管皮瓣修复环、小指软组织缺损

目的探讨吻合神经的尺神经手背支营养血管皮瓣修复环、小指软组织缺损的可行性及临床效果。方法利用尺神经手背支营养血管皮瓣修复环、小指软组织缺损18例,对皮瓣旋转点进行改良,最远达近指间关节平面,11例将皮瓣内皮神经与受区内指神经吻合,以扩大皮瓣修复范围并重建受区感觉。结果皮瓣全部成活,皮瓣质地良好,手部外形与功能恢复满意,皮瓣恢复保护性感觉。结论该皮瓣手术操作简单,经改良后转位灵活,可恢复部分感觉,是修复环、小指软组织缺损的理想皮瓣。

Soft Tissue and Sensation Reconstruction in Ring and Little Fingers using Cutaneous Neurovascular Flap Based on the Dorsal Branch of Ulnar Nerve

Objective To investigate clinical reliability and results of cutaneous neurovascular flap based on the dorsal branch of ulnar nerve for coverage of soft tissue defects and reconstruction of sensation in ring and little fingers.Methods?18 cases were included in this series.We modified the pivot point of the flap to the lateral of the PIP joint.In 11 cases of finger pulp coverage,nerve coaptation was performed between the cutaneous nerve of the flap and the recipient digital nerve.Results?All cases survived completely.The appearance,sensation and function were satisfactory.Conclusion?Cutaneous neurovascular flap based on the dorsal branch of ulnar nerve is easy to operate.some of which can recover partial sense.By modifying the pivot point of the flap,the survival and repairable area of the flap were enlarged.It is an ideal flap for repair of soft tissue loss in ring and little fingers.