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"指固有动脉" 6 results
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Objective
To investigate the effectiveness of cross finger flap pedicled with the dorsal branch of proper digital artery in repairing degloving injury of the fingertip.
Methods
Between January 2010 and June 2012, 13 cases of degloving injury of single fingertip were treated, including 9 males and 4 females with an average age of 33.6 years (range, 17-46 years). The defect locations were index finger in 5 cases, middle finger in 3 cases, ring finger in 3 cases, and little finger in 2 cases, including 4 cases of mechanical injury, 6 cases of twist injury, and 3 cases of crushing injury. The extent of skin avulsion was beyond the distal interphalangeal joint. The length of the avulsion was 1.0-2.1 cm (mean, 1.8 cm). Complicated injuries included phalangeal fracture in 2 cases. The time from injury to operation was 90-330 minutes (mean, 150 minutes). The wound was repaired with the cross finger flap pedicled with the dorsal branch of proper digital artery. The size of flaps ranged from 3.2 cm × 2.3 cm to 4.2 cm × 3.1 cm. After 3-4 weeks, the pedicle was cut. The donors were closed by skin graft.
Results
Tension blisters of the flap and partial necrosis of skin graft occurred in 3 cases and in 1 case respectively, which were cured after symptomatic treatment; the flap and skin graft survived, and primary healing was obtained in the other cases. Thirteen patients were followed up 6-10 months (mean, 7 months). The texture and appearance of all the flaps were satisfactory. At 6 months after operation, two-point discrimination ranged from 7 to 10 mm (mean, 8.1 mm). The total active movement of the fingers were excellent in 10 cases and good in 3 cases, and the excellent and good rate was 100%.
Conclusion
The treatment of degloving injury of fingertip with the cross finger flap pedicled with the dorsal branch of proper digital artery is recommendable for the advantages of reliable blood supply, simple operation, high survival rate of the flap, good function recovery of the finger, and satisfactory appearance.
Release date:2016-08-31 10:53
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目的
总结指固有动脉中段背侧支岛状皮瓣移位修复指间关节背侧皮肤软组织缺损的疗效。
方法
2008年3月-2012年5月,收治36例38指指间关节背侧皮肤缺损患者。男19例20指,女17例18指;年龄17~63岁,平均38岁。损伤原因:挤压伤10例,压砸伤6例,热压伤2例,机器绞伤8例,电锯伤7例,交通事故伤3例。病程1 h~34 d,平均4 h。损伤指别:示指9指,中指13指,环指11指,小指5指。皮肤缺损范围为0.6 cm × 0.4 cm~2.1 cm × 1.8 cm。采用大小为0.7 cm × 0.5 cm~2.3 cm × 2.0 cm的指固有动脉中段背侧支岛状皮瓣移位修复。供区行全厚皮片打包缝合。 结果术后皮瓣及供区植皮均成活,创面Ⅰ期愈合。36例均获随访,随访时间6个月~1年11个月,平均10个月。皮瓣质地、色泽、外形良好。末次随访时,指关节采用手部总主动活动度(TAM)评价法评定:获优29指,良8指,可1指,优良率达97.4%。 结论采用指固有动脉中段背侧支岛状皮瓣移位修复近、远侧指间关节背侧皮肤软组织缺损,是一种较理想的方法。
Release date:2016-08-31 04:07
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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
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目的 总结重建感觉的指固有动脉穿支蒂逆行岛状皮瓣修复手指软组织缺损伴骨外露的临床疗效。 方法 2006 年9 月- 2010 年9 月,应用携带指固有神经背支或桡神经终支的指固有动脉穿支蒂逆行岛状皮瓣修复23 例26 指手指中末节软组织缺损伴骨外露。男14 例,女9 例;年龄15 ~ 60 岁,平均38 岁。示指10 指,中指9 指,环指7 指。创面范围为1 cm × 1 cm ~ 3 cm × 2 cm。病程1 h ~ 14 d。术中皮瓣切取范围为1.5 cm × 1.0 cm ~ 3.5 cm × 2.0 cm,供区全厚皮片植皮修复。 结果 术后1 例皮瓣出现远端青紫,经对症处理后成活;其余皮瓣及植皮均顺利成活,创面Ⅰ期愈合。术后14 例16 指获随访,随访时间6 ~ 12 个月,平均8 个月。皮瓣外形无臃肿,色泽、质地良好。术后6 个月根据手指总主动活动度(TAM)评定法:获优11 指,良4 指,可1 指。皮瓣感觉功能评定:S2 1 指,S3 2 指,S4 3 指,S5 10 指。 结论 采用重建感觉的指固有动脉穿支蒂逆行岛状皮瓣修复手指软组织缺损具有手术操作简便、供区隐蔽、血供可靠、成功率高的优点;术后可重建手指精细感觉,最大程度恢复手指功能。
Release date:2016-08-31 05:44
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Release date:2016-09-01 09:29
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目的 总结间指皮瓣修复手指指端皮肤软组织缺损的疗效。 方法 2012 年 2 月—2017 年 7 月,收治 21 例手指指端皮肤软组织缺损患者。男 15 例,女 6 例;年龄 16~48 岁,平均 35.6 岁。致伤原因:机器伤 12 例,重物压砸伤 5 例,绳索绞伤 2 例,电锯伤 2 例。示指 8 例,中指 5 例,环指 6 例,小指 2 例。受伤至入院时间 30 min ~3 d,平均 2.5 h。单纯指腹缺损 7 例,合并末节指骨远端缺损 14 例;皮肤软组织缺损范围 1.4 cm×1.2 cm~2.4 cm×1.4 cm。均存在邻指中节指背皮肤损伤。于间隔手指中节背侧设计皮瓣,皮瓣范围为 1.6 cm×1.3 cm~2.6 cm×1.6 cm。术后 3~4 周皮瓣断蒂。供区游离植皮修复。 结果 手术时间 1.5~2.2 h,平均 1.7 h。术后 1 例出现张力性水疱,余 20 例皮瓣均成活良好。供区皮片均成活。患者术后均获随访,随访时间 6~30 个月,平均 10.5 个月。修复手指指端饱满,色泽正常;皮瓣两点辨别觉为 5~9 mm,平均 7.2 mm。术后按中华医学会手外科学会上肢部分试用标准评定患指功能:优 16 例,良 4 例,可 1 例,优良率为 95.2%。 结论 邻指皮瓣不能应用时,采用间指皮瓣移植修复手指指端皮肤软组织缺损具有切取简便、皮瓣血管解剖恒定、供区损伤小、术后患指外形和功能良好等优点。
Release date:2018-12-04 03:41
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