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find Keyword "手指屈曲挛缩畸形" 2 results
  • 指动脉顺行岛状皮瓣修复再植术后指间关节严重屈曲挛缩畸形并动脉缺损

    目的 总结应用指动脉顺行岛状皮瓣修复手指再植术后指间关节严重屈曲挛缩畸形并动脉缺损的临床疗效。 方法 2010年3月-2012年6月,收治9例9指手指再植术后指间关节严重屈曲挛缩患者,再植术均吻合一侧指固有动脉。男5例,女4例;年龄21~58岁,平均34.7岁。损伤指别:示指2例,中指3例,环指3例,小指1例。近侧指间关节屈曲挛缩6例,远侧3例。病程6~18个月,平均10.5个月。按照Stern等的指间关节屈曲挛缩分型标准,均为Ⅲ型。术中瘢痕切除、手指伸直后,均伴肌腱外露,掌侧皮肤软组织缺损范围2.5 cm × 1.0 cm~4.5 cm × 2.5 cm,动脉缺损1.5~4.0 cm。于相应供指切取大小为2.7 cm × 1.2 cm~4.7 cm × 2.6 cm的指固有动脉顺行岛状皮瓣移位修复;供区采用中厚皮片游离植皮修复。 结果术后患指皮瓣及植皮均成活,创面及切口均Ⅰ期愈合。患者均获随访,随访时间8~18个月,平均12.6个月。皮瓣质地柔软,无明显色素沉着和瘢痕形成,患指无冷不耐受,外形及主动屈伸活动恢复满意。末次随访时按照中华医学会手外科学会上肢部分功能评定试用标准评定:获优6例,良3例,优良率为100%。 结论指动脉顺行岛状皮瓣是修复再植术后指间关节严重屈曲挛缩畸形并动脉缺损有效方法之一。

    Release date:2016-08-31 04:07 Export PDF Favorites Scan
  • MICROSURGERY FOR SEVERE FLEXION CONTRACTURE OF PROXIMAL INTERPHALANGEAL JOINT

    Objective To investigate the cl inical results of cross-finger flap combined with laterodigital pedicled skin flap for repair of severe flexion contracture of the proximal interphalangeal joint. Methods Between October 2008 and February 2011, 11 patients (11 fingers) with severe flexion contracture of the proximal interphalangeal joint were treated with cross-finger flap combined with laterodigital pedicled skin flap. There were 7 males and 4 females, aged 20-63 years (mean, 32.6years). The causes of injury were crush or electric-saw injury in 7 cases, burn or explosive injury in 3 cases, and electrical injury in 1 case. The locations were the index finger in 4 cases, the middle finger in 2 cases, the ring finger in 2 cases, and the l ittle finger in 3 cases. The mean disease duration was 12.4 months (range, 6-24 months). All cases were rated as type III according to Stern classification standard. The volar tissue defect ranged from 3.0 cm × 1.5 cm to 5.0 cm × 2.5 cm, with exposed tendons, nerves, vessels, or bone after scar relaxation. The defects were repaired with cross-finger flaps (2.2 cm × 1.8 cm to 3.8 cm × 2.5 cm) combined with laterodigital pedicled skin flaps (1.5 cm × 1.2 cm to 2.5 cm × 2.0 cm). Double laterodigital pedicled skin flaps were used in 3 cases. The flap donor site was sutured directly or repaired with the skin graft. Results All flaps survived completely and wound healed by first intention. The donor skin graft survived. All the patients were followed up 6-18 months (mean, 11.3 months). The finger appearance was satisfactory. The flaps had soft texture and good color in all cases. No obvious pigmentation or contraction was observed. The contracted fingers could extend completely with good active flexion and extension motion. At last follow-up, the extension of the proximal interphalangeal joint was 10-15°. Based on proximal interphalangeal joint motion standard of Chinese Medical Association for hand surgery, the results were excellent in 6 cases, good in 4 cases, and fair in 1 case; the excellent and good rate was 90.9%. Conclusion It is an easy and simple therapy to cover wound area of severe flexioncontracture of the proximal interphalangeal joint after scar relaxation using cross-finger flap combined with laterodigital pedicled skin flap, which can repair large defect and achieve good results in finger appearance and function.

    Release date:2016-08-31 04:23 Export PDF Favorites Scan
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