风筝皮瓣在拇指损伤修复及功能重建中的应用

目的研究风筝皮瓣在拇指损伤修复及其功能重建中的应用效果。方法选取我院2008--2012年间收治的100例拇指损伤患者，将其随机分为实验组和对照组各50例。对照组采用腹部皮片植皮，实验组取掌背动脉风筝皮瓣修复拇指掌侧缺损，并使用皮瓣桡侧神经吻合及髂骨移植等方式重建拇指骨结构及感觉功能。对术后皮瓣存活情况、患者神经功能及拇指运动功能进行评价。结果实验组50例患者皮瓣全部存活（100％），再造拇指形态良好；对照组50例存活48例（96％），且外形及质地等均较差。实验组优良率为100％，显著高于对照组的88％（P〈0．05）。实验组感觉恢复更好，S3级以上者实验组有45例（90％），显著高于对照组的36例（72％）。两点分辨距离（2PD）实验组平均为（7．9±0．6）mm显著优于对照组的（10．4±1．2）mm（P〈0．05）。结论风筝皮瓣取用简单，旋转方便，血运可靠，成活率高，对于拇指损伤修复及功能重建有较好治疗效果。

Application of kite flap to thumb injury repair and functional reconstruction

Objective To study the application of kite flap to thumb injury repair. Methods A total of 100 patients with thumb injury admitted to our hospital between the year of 2008 and 2012 were randomly divided into experimental group and control group （ n = 50/group）. The control group was treated with abdominal skin graft, and the experimental group was treated with palm thumb repair with dorsal metacarpal artery kite flap, as well as neurorrhaphy and lilac bone graft. Flap survival, neurological function and thumb movement were evaluated. Results In the experimental group, all the skin flaps survived （ with a survival rate of 100% ） with a good shape in thumb reconstruction. In the control group, the skin flaps survived in 48 patients （with a survival rate of 96% ） with a poor shape and texture. The excellent rate of the experimental group was 100% , significantly higher than that （88%） of the control group （P 〈0.05）. The experimental group was better in sensory recovery. There were 45 （90%） patients with over S3 level in the experimental group, significantly higher than that [ 36, （72%） ] in the control group. The average two- point discrimination （2PD） was （7.9±0.6） mm in the experimental group, significantly better than that （ 10.4 ± 1.2） mm in the control group （ P 〈 0.05 ）. Conclusion Kite flap is simple in application and rotation with a reliable blood supply and a high sur- vival rate, which is therapeutically effective on thumb injury repair and functional reconstruction.