前臂后皮神经营养血管远端蒂皮瓣在拇指再造中的应用

目的探讨前臂后皮神经营养血管远端蒂皮瓣在拇指严重缺失再造中的临床应用疗效。方法采用前臂后皮神经营养血管远端蒂皮瓣对9例拇指严重缺失患者的（其中Ⅴ度6例，Ⅵ度3例）手部皮肤缺损进行修复，重建虎口，同时完成拇指再造。结果9例再造拇指及皮瓣全部成活，均获3～18个月随访，再造拇指功能及皮瓣外形良好，按中华医学会手外科学会上肢部分功能评定试用标准评定：优2例，良4例，可2例，差1例。结论前臂后皮神经营养血管远端蒂皮瓣质地良好，切取安全、简便，不需吻合血管，成活率高，利用它修复严重拇指缺失再造中的手部皮肤缺损并重建虎口．可较好地恢复拇指的外形与功能。

Application of the compound flap pedicled with nutritional vessels of the posterior cutaneous nerve of forearm in reconstruction of thumb

objective To investigate the clinical effect of the compound flap pedicled with nutritional vessels of the posterior cutaneous nerve of forearm in reconstruction of thumb. Methods From August 2007 to February 2011, 9 cases with serious thumb defects were treated in our department. Design and incide the compound flap pedicled with nutritional vessels of the posterior cutaneous nerve of forearm to restore the skin defect, reconstruct hukou of thumbs at equal pace. Results All the thumbs and the flaps survived. Both shape and function of the thumbs were satisfied. Conclusion In reconstruction of serious thumb defects, the compound flap pedicled with nutritional vessels of the posterior cutaneous nerve of forearm are effective to restore the defect of skin. It is a good option to reconstruct shape and function of the defect thumb.