改良拇指桡侧筋膜蒂皮瓣修复拇指软组织缺损

发布时间：2018-03-13 03:26

  本文选题：拇指　切入点：筋膜蒂皮瓣　出处：《中国修复重建外科杂志》2017年07期 　论文类型：期刊论文

【摘要】：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2.0 cm×1.2 cm~3.0 cm×2.5 cm。受伤至手术时间为16 h~2 d,平均30.4 h。皮瓣切取范围2.3 cm×1.5 cm~3.3 cm×2.8 cm;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。
[Abstract]:Objective to investigate the clinical effect of a modified radial fasciocutaneous flap of thumb for the repair of thumb soft tissue defect. Methods from June 2015 to December 2016, the modified radial fasciocutaneous flap with distal fascia pedicle was used. 15 cases of soft tissue defect of dorsal palm of thumb were repaired. There were 11 males and 4 females, aged 3570 years, with an average age of 46 years. The causes of injury were crush injury in 12 cases and avulsion injury in 3 cases. No replantation condition or replantation desire. Palmar defect of thumb in 12 cases, dorsal defect in 3 cases; The area of wound defect was 2.0 cm 脳 1.2 cm~3.0 cm 脳 2.5 cm, the average time from injury to operation was 30.4 h. The skin flap was cut at 2.3 cm 脳 1.5 cm~3.3 cm 脳 2.8 cm, and the donor area was sutured directly. Results the flap survived without swelling and tension blister. The donor area and wound surface were all healed in stage 鈪，

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