同指顺行神经血管蒂岛状皮瓣修复指腹指端缺损

目的探讨同指顺行神经血管蒂岛状皮瓣修复指腹、指端缺损的手术疗效。方法23例指腹或指端缺损的患者，采用同指顺行带指神经血管蒂皮瓣移位修复。切取皮瓣面积1．3cm×1．5cm～2．0cm×2．5cm。结果23例皮瓣全部成活，无静脉回流障碍，供区创面一期愈合，术后随访6～16个月，皮瓣外形满意、质地柔软、弹性好、色泽与正常接近，皮瓣不臃肿能耐寒，伤指无疼痛。两点分辨觉达6～10mm。手功能按TAM法评定，优13指，良8指，可2指，优良率达91％。结论同指顺行带指神经血管蒂岛状皮瓣移位，皮瓣供区靠近创面，手术方法简便，术后功能及外形满意，是治疗指腹、指端缺损的一种比较理想的术式选择。     

同指带指神经血管拇背尺侧岛状皮瓣修复拇指腹缺损

目的探讨拇指指腹缺损的显微修复方法。方法对9例拇指指腹缺损的患者,采用同指带指神经血管拇背尺侧岛状皮瓣移位修复。皮瓣缺损面积为2．0cm×1．5cm～3．0cm×3．0cm。结果 9例皮瓣全部成活,术后随访3～6个月,皮瓣外形满意,质地柔软,弹性好,两点分辨觉达6mm～10mm,拇指屈伸活动良好。结论同指带指神经血管蒂拇背尺侧岛状皮瓣移位,手术方法简单,术后功能、外形满意,是一种修复拇指指腹缺损较理想的术式选择。     

同指带指动脉、神经蒂顺行岛状皮瓣修复末节指腹软组织缺损

目的 探讨同指带指动脉、神经蒂顺行岛状皮瓣修复末节指腹软组织缺损的临床效果。方法 根据末节指腹软组织缺损的情况，对25例此类患者采取同指带指动脉、神经蒂顺行岛状皮瓣覆盖创面，供区直接缝合，通过随访观察手指外形，感觉及功能恢复情况，了解临床疗效，总结优缺点。结果 1～12个月，平均6个月，25例同指带指动脉、神经蒂顺行岛状皮瓣全部成活，患者对手指外形，感觉及功能比较满意。结论 同指带指动脉、神经蒂顺行岛状皮瓣具有易于切取，对供区影响小，外形良好，皮瓣感觉良好等优点，是带感觉修复末节指腹软组织缺损的较好方法。     

同指螺旋岛状皮瓣修复指腹缺损

目的：探讨同指螺旋岛状皮瓣修复指腹缺损的方法和临床疗效。方法：自2007年6月至2009年10月,采用以同指一侧指固有神经血管柬为蒂螺旋岛状皮瓣向前推进修复指腹缺损16例16指,男12例,女4例;年龄18～49岁,平均37岁。机器挤伤11例,重物砸伤2例,车门挤伤1例,电锯伤2例。损伤指别：食指5例．中指9例,环指2例。均为全指腹缺损,缺损范围：1．6cm×1．2cm-2．5cm×1．7cm,指背供区植皮。结果：皮瓣全部成活,创面I期愈合,全部病例均获随访,时间8-20个月,平均12个月,手指外形良好,皮瓣质地软,静止两点辨别觉为5～7mm,平均为5．1mm。按照手指总主动活动度评级标准（TAM）,优7例,良8例,中1例。结论：采用同指螺旋岛状皮瓣修复指腹缺损,手术操作简便,可获得良好临床疗效。     

指动脉逆行岛状皮瓣修复指腹缺损

目的报道应用吻合指固有神经掌皮支的指动脉逆行岛状皮瓣修复指腹缺损的临床效果。方法对15例16指末节指腹缺损的患者,应用吻合指固有神经掌皮支的指动脉逆行岛状皮瓣修复,皮瓣切取面积为1.8cm×2.1cm~3.1cm×3.6cm。结果15例皮瓣全部成活,术后随访6个月~2年,伤指外形与正常指相近,指腹饱满而不臃肿,质地柔软,有排汗功能,两点分辨觉在5~7mm以内。结论应用吻合指固有神经掌皮支的指动脉逆行岛状皮瓣,术后效果好,供区损伤小,是修复末节指腹缺损较理想的手术方法。     

指动脉顺行岛状皮瓣修复指端缺损

目的 探讨指动脉顺行岛状皮瓣修复指端缺损的临床效果.方法 2005年12月至2008年10月,采用指动脉顺行岛状皮瓣修复63例72指指端软组织缺损,最大面积为21 mm×27mm,最小为8 mm×11 mm.结果 63例72指皮瓣全部成活,术后随访4～19个月,功能及外观效果满意,两点辨别觉7～9 mm,平均8 mm,手功能TAM法测定:优59指,良11指,可2指.结论 该手术方法操作简便、安全,是修复指端缺损较为理想的方法.     

指动脉顺行岛状皮瓣修复指端缺损

Objective To investigate the therapeutic effect of island flaps pedieled with digital artery for the defects at the end of fingers. Methods 63 eases with 72 soft tissue defects at the end of fingers were treated with the island flaps. The flap size ranged from 8 mm× 11 mm to 21 nun × 27 ram. Results All the flaps survived completely. The follow-up period ranged from 4 to 19 months. The functional and cosmetic results were satisfactory. The two-point discrimination was 7 ～ 9 mm. The TAM functional examination showed excellent in 59 fingers, good in 11 fingers and common in 2 fingers. Conclusions The technique with island flap is simple and reliable for the defects at the end of fingers.     

指动脉顺行岛状皮瓣修复指端缺损

Objective To investigate the therapeutic effect of island flaps pedieled with digital artery for the defects at the end of fingers. Methods 63 eases with 72 soft tissue defects at the end of fingers were treated with the island flaps. The flap size ranged from 8 mm× 11 mm to 21 nun × 27 ram. Results All the flaps survived completely. The follow-up period ranged from 4 to 19 months. The functional and cosmetic results were satisfactory. The two-point discrimination was 7 ～ 9 mm. The TAM functional examination showed excellent in 59 fingers, good in 11 fingers and common in 2 fingers. Conclusions The technique with island flap is simple and reliable for the defects at the end of fingers.     

指动脉顺行岛状皮瓣修复指端缺损

Objective To investigate the therapeutic effect of island flaps pedieled with digital artery for the defects at the end of fingers. Methods 63 eases with 72 soft tissue defects at the end of fingers were treated with the island flaps. The flap size ranged from 8 mm× 11 mm to 21 nun × 27 ram. Results All the flaps survived completely. The follow-up period ranged from 4 to 19 months. The functional and cosmetic results were satisfactory. The two-point discrimination was 7 ～ 9 mm. The TAM functional examination showed excellent in 59 fingers, good in 11 fingers and common in 2 fingers. Conclusions The technique with island flap is simple and reliable for the defects at the end of fingers.     

指动脉顺行岛状皮瓣修复指端缺损

Objective To investigate the therapeutic effect of island flaps pedieled with digital artery for the defects at the end of fingers. Methods 63 eases with 72 soft tissue defects at the end of fingers were treated with the island flaps. The flap size ranged from 8 mm× 11 mm to 21 nun × 27 ram. Results All the flaps survived completely. The follow-up period ranged from 4 to 19 months. The functional and cosmetic results were satisfactory. The two-point discrimination was 7 ～ 9 mm. The TAM functional examination showed excellent in 59 fingers, good in 11 fingers and common in 2 fingers. Conclusions The technique with island flap is simple and reliable for the defects at the end of fingers.     

同指掌侧脂肪筋膜瓣修复指腹软组织缺损

目的探讨同指掌侧脂肪筋膜瓣修复指腹合并肌腱、骨外露软组织缺损疗效。方法采用同指掌侧脂肪筋膜瓣转移联合植皮修复指腹软组织缺损18例20指。结果术后18指供受区创面Ⅰ期愈合,2指移植皮片坏死,二期修复。18例均获随访,时间3～12个月,皮瓣颜色正常,指间关节活动正常,外形美观。结论同指掌侧脂肪筋膜瓣转移联合植皮术,简单安全,能够一次完成手术,利于患指术后护理和功能锻炼,是修复指腹深部软组织缺损一种可行方法。     

不同术式的指动脉岛状皮瓣修复指腹缺损

目的探讨不同术式的指动脉岛状皮瓣修复指腹缺损的临床效果。方法56例（56指）指腹缺损,应用邻指指动脉顺行岛状皮瓣修复拇指指腹4指,指动脉逆行岛状皮瓣修复2～5指指腹25指,带指神经血管蒂的岛状推进皮瓣修复2～4指指腹15指,指动脉背侧支逆行岛状皮瓣修复2～4指指腹6指,吻合血管的指动脉顺行岛状皮瓣修复示指指腹合并血管神经缺损2指,邻指带皮蒂的指动脉逆行岛状皮瓣中指指腹4指。皮瓣切取面积为1.5 cm×2.0 cm～3.0 cm×4.0 cm。结果56指皮瓣全部成活。随访1～2年,指腹外形满意,感觉恢复良好,指腹感觉按中华医学会手外科学会上肢部分功能评定试用标准评定：33指恢复至S4,13指恢复至S3＋,7指恢复至S3,3指恢复至S2。结论灵活应用不同术式的指动脉岛状皮瓣修复指腹缺损,手术简便易行、安全、效果好。     

带神经的同指螺旋状顺行岛状皮瓣修复指端缺损

目的 探讨带神经的同指螺旋状顺行岛状皮瓣修复指端缺损的手术效果.方法 2007年3月至2009年6月,对15例指端缺损的患者,在清创术后3～6 d,采用带神经的同指螺旋状顺行岛状皮瓣进行修复.指端皮肤缺损面积为1.5 cn×1.2 cm～2.2 cm×2.0 cm.供区中节指背创面取前臂内侧全厚皮片植皮修复.结果 术后15例皮瓣均未发生血管危象,皮瓣与皮片全部存活.15例随访时间为6～24个月,患指伸、屈功能正常,伤指无疼痛,皮瓣外形满意、质地柔软、有指纹,末节指端静止两点分辨觉为5～6 mm,指侧方静止两点分辨觉为8～10 mm.结论 带神经的同指螺旋状顺行岛状皮瓣修复指端缺损,手术方法简单、可靠,效果满意,是修复指端缺损的一种理想的手术方法.     

指动脉逆行岛状皮瓣修复指腹缺损

目的:报道应用吻合指固有神经背侧支的指动脉逆行岛状皮瓣修复指腹缺损的临床效果。方法:对20例末节指腹缺损的患者应用吻合指固有神经背侧支的指动脉逆行岛状皮瓣修复,皮瓣切取面积1.8cm×2.0cm～3.0cm×3.5cm。结果:20例皮瓣全部成活,术后随访6～12个月,伤指外形与正常指接近,指腹饱满。两点分辨率在6～8cm。结论:应用吻合指固有神经背侧支的指动脉逆行岛状皮瓣,术后效果较好,供区损伤小,是修复末节指腹缺损的较理想的手术方法。     

同指背外侧神经血管岛状皮瓣移位修复指腹缺损

目的探讨同指背外侧岛状皮瓣修复指腹缺损的手术疗效。方法通过应用解剖学研究，发现指固有神经于远侧指间关节附近发出2～3个分支，支配手指远端背外侧皮肤。以该神经血管束背侧支为蒂，设计岛状皮瓣，移位修复指腹缺损，临床应用10例11指。结果10例皮瓣全部成活。术后9例获得随访，随访时间3～6个月。皮瓣质地柔软，外形满意，能耐寒，伤指无疼痛，两点分辨觉达7～10mm，平均8．5mm。手功能按TAM法评定，优7指，良2指，可1指，优良率达90％。结论同指背外侧岛状皮瓣手术方法简单，疗效满意，是治疗指腹缺损的一种可行手术方法。     

指背侧岛状皮瓣修复手指皮肤缺损

目的探讨带一侧指动脉的指背侧岛状皮瓣修复手部软组织缺损的临床应用价值。方法从1998年起,应用指背侧岛状皮瓣11例,修复手指掌背侧皮肤缺损,范围2.0cm×1.0cm～2.5cm×4cm。结果术后皮瓣全部成活,随诊1～18个月,手指外观不臃肿,色泽质地好,外形满意,供区隐蔽,对供指功能无影响。结论指背侧岛状皮瓣操作相对简便,血供稳定,成活率高,是修复手部缺损的好方法     

Reconstruction of finger pulp defect with reversed fasciocutaneous island flap from same finger

Objective:To investigate the clinical curative effect of reconstruction of finger pulp defect by anastomosis of reversed fasciocutaneous island flap with dorsal branch of the digital nerve of the same finger. Methods: The restoration of finger pulp defect with fasciocutaneous island flap from the same finger was conducted in 25 cases (30 fingers) from January 2002 to June 2003. Nine patients (11 fingers) whose flaps with dorsal branch of the digital nerve anastomosed with the digital inherent nerve around the surface of the wound were Group A and the others were Group B. The follow-up was carried out at 3 and 9 months after the operation to observe the shape of finger pulp and the sense restoration between two groups. Results: All flaps of 25 cases (30 fingers) survived. Three months after operation, the patients had fully grown finger pulps and recovered the superficial sensation and tactile sense of finger pulps. The two point discrimination on average was 5. 00 mm±0. 23 mm in Group A and 6.00 mm±0.30 mm in Group B. The difference between two groups was highly significant. Nine months later, their senses of finger pulps between two groups were recovered basically. Conclusions: The reversed fasciocutaneous island flap from the same finger is the first choice to reconstruct the finger pulp defect, and the anastomosis of dorsal branch of the digital nerve shall be determined according to the specific condition.