改良拇指桡侧筋膜蒂皮瓣修复拇指软组织缺损
目的探讨一种改良拇指桡侧筋膜蒂皮瓣修复拇指软组织缺损的临床疗效。方法2015年6月-2016年12月，采用筋膜蒂远端切断的改良拇指桡侧筋膜蒂皮瓣，修复15例拇指掌背侧软组织缺损患者。其中男11例，女4例；年龄35～70岁，平均46岁。致伤原因：挤压伤12例，撕脱伤3例。均为拇指掌背侧软组织缺损伴肌腱或骨组织外露，无再植条件或再植欲望。拇指掌侧缺损12例，背侧缺损3例；创面缺损范围为2．0cm×1．2cm～3．0cm×2．5cm。受伤至手术时间为16h-2d，平均30．4h。皮瓣切取范围2．3cm×1．5cm～3．3cm×2．8cm；供区均直接缝合。结果术后皮瓣均成活，无极度肿胀和张力性水疱发生...
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| Published in | 中国修复重建外科杂志 Vol. 31; no. 7; pp. 841 - 844 |
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| Main Author | |
| Format | Journal Article |
| Language | Chinese |
| Published |
2017
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| Subjects | |
| Online Access | Get full text |
| ISSN | 1002-1892 |
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| Summary: | 目的探讨一种改良拇指桡侧筋膜蒂皮瓣修复拇指软组织缺损的临床疗效。方法2015年6月-2016年12月，采用筋膜蒂远端切断的改良拇指桡侧筋膜蒂皮瓣，修复15例拇指掌背侧软组织缺损患者。其中男11例，女4例；年龄35～70岁，平均46岁。致伤原因：挤压伤12例，撕脱伤3例。均为拇指掌背侧软组织缺损伴肌腱或骨组织外露，无再植条件或再植欲望。拇指掌侧缺损12例，背侧缺损3例；创面缺损范围为2．0cm×1．2cm～3．0cm×2．5cm。受伤至手术时间为16h-2d，平均30．4h。皮瓣切取范围2．3cm×1．5cm～3．3cm×2．8cm；供区均直接缝合。结果术后皮瓣均成活，无极度肿胀和张力性水疱发生；供区及创面均I期愈合。15例患者均获随访，随访时间3～12个月，平均6个月。筋膜蒂皮瓣色泽与周围组织相近，无明显臃肿，外观满意。末次随访时按照总主动活动度法评定手功能，获优8例，良7例。结论采用改良拇指桡侧筋膜蒂皮瓣修复拇指软组织缺损具有损伤小、手术操作简便的优点，同时可获得可靠的临床疗效。 |
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| Bibliography: | 51-1372/R Objective To investigate the operative method of repairing soft tissue defect of the thumb with modified radial dorsal fasciocutaneous flap and its effectiveness. Methods Between June 2015 and December 2016, 15 patients with volar or dorsal defects of the thumb were treated with modified radial dorsal fasciocutaneous flaps which distal pedicles were cut off. Of 15 cases, 11 were male and 4 were female, aged 35-70 years （mean, 46 years）. The causes of injury included crush injury in 12 cases and avulsion injury in 3 cases. Because all patients had volar or dorsal defects of the thumb which were accompanied by tendon or bone exposure, they had no condition or desire to replant. There were 12 cases ofvolar defect of thumb and 3 cases of dorsal defect. The area of defects ranged from 2.0 cm×1.2 cm to 3.0 cm× 2.5 cm. The time between injury and operation was 16 hours to 2 days （mean, 30.4 hours）. The radial dorsal fascio- cutaneous flaps of 2.3 cm×1.5 cm to 3.3 cm×2.8 cm in size were adopted to repair def |
| ISSN: | 1002-1892 |