吻合指背神经的指动脉终末背支逆行岛状皮瓣修复指端缺损（附视频）

目的探讨吻合指背神经的指动脉终末背支逆行岛状皮瓣修复指端软组织缺损及甲床缺损的方法与效果。方法应用吻合指背神经的指动脉终末背支岛状皮瓣逆行转移修复20例25指，其中示指8指、中指12指、环指5指。创面面积最小为1．0cm×1．8cm，最大为1．6cm×2．1cm。指背神经与指掌侧固有神经吻合，重建指端皮瓣感觉。结果术后25指皮瓣全部存活。平均随访（10．0±1．2）个月（6～12个月），皮瓣外形美观，感觉恢复S2～S3＋级，远指间关节活动基本正常。结论此方法具有患指感觉恢复良好、不损伤指掌侧固有动脉和神经、手术操作简便、风险小等优点，是临床修复指端缺损的较好方法。

Reverse mini- flaps based on the end dorsal branches of the digital artery for repairing the defects of the fingertips

Objective To investigate the outcome of the reverse miniflap based on the end dorsal branches of the digital artery for repairing the defects of fingertip soft tissue and finger nails. Methods Twentyfive fingers of defects （ 8 index fingers, 12 middle fingers, and 5 ring fingers ） from 20 patients were repaired by the reverse miniflaps based on the end dorsal branches of the digital artery according to the shapes and sizes of the defects in each finger. The smallest size of the flap was 1.0 cm × 1.8 cm, while the biggest one was 1.6 cm× 2. 1 era. The dorsal digital nerves were anastomosized to the proper palmar digital nerves for restoring sensation. Results All flaps survived with satisfactory appearance and good sensation（ranging from S2 to S3 plus）. The distal interphalangeal joint nearly restored the normal movement over 6-12 months follow up. Conclusion The surgical technique is a good method for repairing the defects of fingertips with advantages of relatively simple procedures, high survival rate, and no injury of proper palmar digital arteries and nerves.