改良Moberg岛状皮瓣修复远节指腹缺损

目的:探讨改良Moberg推进皮瓣修复指端指腹皮肤缺损。方法:采用改良Moberg岛状推进皮瓣治疗指端掌侧缺损16例,平均随访8个月。对Moberg皮瓣的改良包括在皮瓣近端采用双边"Z"成形,远端克氏针牵引。游离皮瓣仅保留神经血管蒂,内含双侧指固有神经和一侧指固有血管,保留指背神经的连续性。结果:皮瓣全部成活,在外观、感觉以及运动功能等方面疗效满意,术后3月手指活动TAM优良率为83.3%(15/18),指端两点辨别觉达到5mm以内。结论:改良Moberg岛状推进皮瓣进一步增加了推进距离,术后功能恢复良好,并发症少。

Repair of Soft Tissue Defect of Finger Pulp with Modified Moberg Flap

Objective：To report the result of modified Moberg flap for repair the defects of finger pulp.Method：From March 2005 to May 2007,16 cases（18 defective finger pulps） were cured with modified Moberg flap.Except one side of digital artery,the neurovascular bundles were reserved inthe flap and turned into the pedicles with the dorsal digital nerves intact.Z epicanthoplasty was adopted at the proximal side of the flap,furthermore,theterminal side of the flap was tract by a Kirschner wire at the top of the finger tip.Result：The mean following-up was 8 months.All the flaps survived.Theclinical results were satisfactory,including sensibility and joint activity.The excellent and good rate of TAM fingers activities was 15/18（83.3%）,two-points discrimination were less than 5 mm within 3 months after operation.Conclusion：Repair of soft tissue defect of finger pulp with this kind of modifiedMoberg flap resulted in reliable curative effect,not only advancing more distance,but also keeping complications down.