Repair of soft tissue defect of the thumb by flaps

LI Jun-ming; et al

doi:10.13406/j.cnki.cyxb.2010.11.022

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Repair of soft tissue defect of the thumb by flaps

更新时间：2024-01-17

- Repair of soft tissue defect of the thumb by flaps
- Journal of Chongqing Medical University Vol. 35, Issue 11, Pages: 1719-1721(2010)
- 作者机构：
  
  漯河医学高等专科学校第二附属医院骨科
- 作者简介：
- 基金信息：
- DOI：10.13406/j.cnki.cyxb.2010.11.022
  CLC： R658.2
- Published：2010，
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[1]李俊明,郑水长,李道选,易先达,蔡喜雨,张志敏,黄贺军.拇指皮肤软组织缺损的皮瓣修复[J].重庆医科大学学报,2010,35(11):1719-1721.

LI Jun-ming, et al. Repair of soft tissue defect of the thumb by flaps. [J]. Journal of Chongqing Medical University 35(11):1719-1721(2010)
[1]李俊明,郑水长,李道选,易先达,蔡喜雨,张志敏,黄贺军.拇指皮肤软组织缺损的皮瓣修复[J].重庆医科大学学报,2010,35(11):1719-1721. DOI： 10.13406/j.cnki.cyxb.2010.11.022.

LI Jun-ming, et al. Repair of soft tissue defect of the thumb by flaps. [J]. Journal of Chongqing Medical University 35(11):1719-1721(2010) DOI： 10.13406/j.cnki.cyxb.2010.11.022.

摘要

目的:总结应用5种不同类型的皮瓣修复拇指软组织缺损的临床效果及体会。方法:自2001年1月～2008年12月

应用5种类型的皮瓣（拇背侧皮神经营养血管皮瓣、中环指指动脉侧方岛状皮瓣、示指背侧皮瓣、踇趾腓侧皮瓣、踇甲皮瓣）共69块修复拇指软组织缺损63例。男42例

女21例;年龄16～59岁

平均32岁。机器伤46例

鞭炮炸伤4例

车祸伤4例

电锯伤4例

烧伤1例

指端再植术后坏死2例

重物砸伤2例。缺损面积:1.5 cm×2.0 cm～4.0 cm×5.0 cm。急诊手术47例

16例延期手术修复。结果:1例示指背侧顺行岛状皮瓣

切取失败

改行其它皮瓣修复

1例趾腓侧皮瓣术后动脉顽固性痉挛致坏死

1例拇指桡背侧皮神经营养血管皮瓣蒂部缝合较紧

出现静脉回流障碍

皮瓣远1/3部分坏死

经换药后愈合

3例皮瓣在术后36～48小时皮瓣明显肿胀

呈淡紫色

皮瓣远端出现表皮下积液、水疱等情况

经处理后皮瓣成活

其余皮瓣未经特殊处理均顺利成活

成功率95.6%。随访6个月～5年

皮瓣外形好、耐磨

吻合神经的24例

皮瓣两点分辨觉在6～9 mm

没有吻合神经的皮瓣由于受区神经的长入也产生了保护性感觉功能

示指背侧顺行岛状皮瓣有异位定位感觉。结论:治疗拇指软组织缺损

应根据病人不同的要求、不同的创面

结合患者的性别、年龄、职业以及皮瓣本身的特点

充分考虑供区的功能和美观要求

权衡利弊

选择合适的皮瓣

才能取得满意的疗效。

Abstract

Objective:The clinical results of 5 types of flaps for the coverage of soft tissue defect of the thumb were presented.Methods:From January 2001 to December 2008

63 patients had accepted thumb reconstruction with 5 types of flaps

47 cases of emergency surgery and 16 cases of delayed surgical repair.Results:57 flaps of fingers survived well;4 flaps necrosed partly

the wound healed by changing the dressing;2 flaps necrosed completely

then other flaps were choosed to treat the defects.The flaps were followed up for 3 months to 5 years

and the contour and function of the injured digits were satisfied.Conclusion:Conditions of the patients

as well as function and appearances of donor and recipient site shound be taken into consideration when a flap is chosen.

关键词

拇指软组织缺损外科皮瓣修复

Keywords

ThumbSoft tissue defectFlaprepair

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Related Institution

Department of Burns and Plastic,the Children’s Hospital,Chongqing Medical University,Ministry of Education Key Laboratory of Child Development and Disorders,Key Laboratory of Pediatrics in Chongqing,Chongqing International Science and Technology Cooperation Center for Child Development and Disorders

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