拇指桡背侧皮神经营养皮瓣修复拇指皮肤软组织缺损

目的探讨拇指背桡侧皮神经营养血管蒂的岛状皮瓣修复拇指软组织缺损的临床效果。方法对19例拇指软组织缺损患者利用拇指背桡侧皮神经营养血管皮瓣修复,其中修复感觉神经15例。缺损面积：1.5cm×1.0cm～2.5cm×2.5cm;皮瓣面积：2.0cm×1.5cm～3.0cm×2.5cm。结果19例皮瓣全部成活。随访5～30个月,皮瓣外观及感觉良好,指腹两点分辨觉为6～10mm。指间关节活动范围0°～80°。结论该皮神经皮瓣手术操作简单,皮瓣外形好,部分皮瓣能恢复感觉,是修复拇指软组织缺损的理想方法。

Thumb soft tissue defect repaired with radial thumb neurocutaneous vasotrophic island flap

Objective To investigate the clinical result of repairing the thumb soft tissue defect with radial thumb neurocutaneous vasotrophic island flap.Methods 19 cases of the thumb soft tissue defect were repaired by radial thumb neurocutaneous vasotrophic island flaps.The area of the defect was between 1.5 cm×1.0 cm and 2.5 cm×2.5 cm.Sensory nerves（15 cases） were repaired.The area of the flap was between 2.0 cm×1.5 cm and 3.0 cm×2.5 cm.Results The flap survived after operation.During a follow-up of 5 to 30 months,the thumb had fine appearance and functioned well,with 6～10 mm two point discrimination（TPD） and 0°～80°in range of motion at IP joint of the thumb.Conclusions Using neurocutaneous vasotrophic island flap is easy to operate and the flap has a good appearance.Moreover,some of the flaps can recover partial sense.It is an ideal method to repair thumb soft tissue defect.