应用拇指桡侧皮神经逆行岛状皮瓣修复拇指末节皮肤缺损

目的选取23例拇指末节皮肤软组织缺损患者，对受试者采用拇指桡侧皮神经逆行岛状皮瓣修复术，并观察患者临床情况，最终得出相应临床研究结论。方法取皮瓣旋转点，即拇指桡侧间指关节以近的任意一点，轴心线为：掌指关节中点偏桡侧1．5cm与指间关节中点偏桡侧1．0cm之间的连线，然后沿该连线切开，使拇指桡侧皮神经切断分离，此时拇指保留1．5cm的筋膜蒂，明道旋转180°，转移至拇指末节皮肤软组织缺损处。结果拇指桡侧皮神经逆行岛状皮瓣修复术后，被选23例拇指末节皮肤软组织缺损患者全部成活，经过5个月至2年的随访活动，皮瓣外形、皮瓣质地以及周围组织相似，供区无明显并发症，且治后功能良好。结论针对拇指末节皮肤软组织缺损症状，拇指桡侧皮神经逆行岛状皮瓣修复术是非常理想的手术方法，疗效显著，值得推崇治疗。

Applications thumb radial cutaneous nerve retrograde island flap for thumb distal skin defects

Objective Selected 23 cases of distal thumb thumb radial cutaneous nerve retrograde island flap surgery subjects, and to observe the clinical situation, the final draw corresponding clinical research conclusions. Methods Flap rotation point, that the thumb joints nearly any point, the axis line： the metacarpophalangeal joints midpoint the partial radial side 1.5 cm interphalangeal joint connection between the midpoint of the partial radial side 1.0 cm then cut along the connection, make the thumb radial leather neurotomy separation, the thumb retention 1.5 cm fascia Ming rotate 180~, transferred to the distal thumb skin defect. The flap minimum maximum area for 2era x 2 cm, 3 cm x 4 cm. Results Thumb radial cutaneous nerve retrograde island flap after repair to be elected to the 23 eases of distal thumb skin defect patients survived after 5 months to 2 years of follow-up activities, flap shape flap texture similar to the surrounding tissue, no significant complications for the district, and good governance after the function. Conclusion Distal thumb skin and soft tissue defect symptoms, the thumb radial cutaneous nerve retrograde island flap surgery is the ideal surgical method, a significant effect, should be respected treatment.