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find Keyword "甲瓣" 7 results
  • 改良邻指皮瓣联合第二趾甲瓣修复手指中末节皮肤脱套伤

    目的 总结采用改良邻指皮瓣联合第2 趾甲瓣修复手指中末节脱套伤的方法及临床疗效。方 法 2005 年 9 月- 2009 年12 月,收治11 例11 指手指中末节皮肤脱套伤患者。男8 例,女3 例;年龄21 ~ 45 岁,平均28 岁。损伤原因:绞伤8 例,挤压伤3 例。损伤指别:示指5 例,中指5 例,环指1 例。皮肤撕脱平面:远指间关节 4 例,中节中部5 例,近指间关节2 例。创面范围6 cm × 3 cm ~ 7 cm × 4 cm。受伤至手术时间2 ~ 4 d,平均3 d。采用3.5 cm ×3.0 cm ~ 4.0 cm × 3.5 cm 的改良邻指皮瓣联合2.5 cm × 2.0 cm ~ 6.0 cm × 2.5 cm 的第2 趾甲瓣修复创面。改良的邻指皮瓣均带有指固有动脉背侧支,蒂宽1.0 ~ 1.5 cm。供区取中厚皮片植皮修复。 结果 术后皮瓣及植皮均顺利成活,供受区切口均Ⅰ期愈合。11 例均获随访,随访时间4 ~ 10 个月。趾甲生长良好,外形较满意。指腹感觉恢复,两点辨别觉为6 ~ 8 mm,平均6.5 mm。手指伸屈功能按手指总主动活动度(TAM)评分法评定,优8 指,良3 例。 结论 改良邻指皮瓣联合第2 趾甲瓣是修复手指中末节皮肤脱套伤的一种较好方法。

    Release date:2016-09-01 09:03 Export PDF Favorites Scan
  • ABSTRACTSFUNCTONAL RESULTS OF THE DONOR FOOT AFTER FREE WARPAROUND FLAP

    linically,free neurovascular warparound flap big toe is generally used as one of the methods forthe reconstruction of thumb. The fate of the donor foot , and the various problems brought about bythe transfer, however, had not drawn enough concentration from the surgeons.Free warparound flap transfer was performed on 107 patients and 62 cases of the total werefollowed-up. It was found that the results of the transfer were generally satisfactory to the thumb,but much were complained about ...

    Release date:2016-09-01 11:32 Export PDF Favorites Scan
  • 股前外侧穿支皮瓣修复甲瓣再造拇指足供区皮肤缺损

    目的总结股前外侧穿支皮瓣修复甲瓣再造拇指足供区皮肤缺损的临床疗效。 方法2010年10月-2012年12月,应用游离甲瓣移植再造拇指缺损10例。其中男7例,女3例;年龄17~45岁,平均26岁。拇指缺损程度按顾玉东分类法:Ⅰ度4例,Ⅱ度3例,Ⅲ度3例。受伤至手术时间2~11d,平均5d。趾供区均采用股前外侧穿支皮瓣修复。 结果10例均获随访,随访时间3~18个月,平均8个月。再造拇指及供区皮瓣全部成活,创面均Ⅰ期愈合。再造拇指外观及掌指关节伸屈活动、拇指对指捏力恢复良好;均恢复了保护性触痛觉,两点辨别觉为10~15mm,平均12mm。足供区趾体外形良好,供趾的屈伸活动无明显影响。随访6个月以上患者步态恢复正常,足部不适感及双侧变异基本消失,奔跑、弹跳基本不受影响。 结论甲瓣移植再造拇指联合股前外侧穿支皮瓣修复是供区缺损的手术方法既能完美再造拇指,又能很好地保留供趾功能。

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  • RECONSTRUCTION OF DEGLOVED THUMBS WITH FREE SECOND TOE DORSAL FLAP COMBINED WITH MIDDLE OR RING FINGER ISLAND FLAP

    ObjectiveTo investigate the effectiveness of free second toe dorsal flap combined with middle or ring finger island flap for repairing degloved thumbs. MethodsBetween August 2009 and June 2013, 6 patients with degloving injury of the thumb were treated using free second toe dorsal flap combined with middle or ring finger island flap. There were 4 males and 2 females, aged 19-44 years (mean, 32 years). The left thumb was involved in 2 cases and the right thumb in 4 cases, including 5 cases of type II and 1 case of type III degloving injury. The size of wound was 5.5 cm×2.5 cm to 6.5 cm×5.0 cm. After emergency debridemented, 5 patients underwent vacuum sealing drainage and surgical repair after 3-5 days; 1 patient underwent abdominal embedding and repair after 14 days. The size of second toe dorsal flap ranged from 2.5 cm×2.2 cm to 4.2 cm×3.0 cm, and the size of middle or ring finger island flap ranged from 2.0 cm×1.5 cm to 3.5 cm×2.8 cm. Neurorrhaphy was performed between the plantar digital nerve of the second toe and the proper digital nerve at the recipient site in 5 cases, and no nerve anastomose in 1 case. All the distal phalanxes were partially excised. The donor sites were covered with free skin grafts. ResultsAll of the flaps survived completely and incision healed by first intention. Three patients had alloesthesia of the middle or ring finger island flaps. All of the 6 patients were followed up from 6 months to 3 years (mean, 23 months). The flaps had good color and soft texture, and the finger had satisfactory appearance, but the fingernails were smaller than that of normal side. The sensation of the dorsum of the second toe reached S3, and the mean two-point discrimination of the pulp was 6 mm (range, 4-7 mm). According to total active movement (TAM) system, the function of the thumbs was excellent in 5 cases and good in 1 case. ConclusionA combination of free second toe dorsal flap and middle or ring finger island flap is a useful and reliable technique for reconstruction of a degloved thumb.

    Release date:2016-11-14 11:23 Export PDF Favorites Scan
  • Repair of the donor defect after wrap-around flap transfer with free thinned innervated anterolateral thigh perforator flap

    Objective To explore the feasibility of harvesting free thinned innervated anterolateral thigh (ALT) perforator flap for repairing the donor defect after wrap-around flap transfer. Methods Between May 2011 and December 2013, free thinned innervated ALT perforator flap was used to repair the donor defects after wrap-around flap transfer in 9 patients. There were 8 males and 1 female, with a mean age of 31.2 years (range, 19-42 years). The interval time between injury and admission was 3-12 hours (mean, 6.5 hours). Injury causes included machine crush injury (4 cases), traffic accident injury (3 cases), and twisting injury (2 cases). The wrap-around flaps were transferred to reconstruct thumb defects. And the size of donor site defect ranged from 3 cm×2 cm to 8 cm×5 cm. A branch of the lateral femoral cutaneous nerve was carried to make innervated ALT perforator flap for donor site repair. The size of innervated ALT perforator flap ranged from 3.0 cm×2.0 cm to 8.5 cm×5.0 cm. The thickness of innervated ALT perforator flap before defatting ranged from 2.0 to 4.5 cm (mean, 3.2 cm); the thickness after defatting ranged from 0.4 to 0.6 cm (mean, 0.5 cm). The defect at the anterolateral thigh was primarily closed in all cases. Results All reconstructed thumbs and ALT perforator flaps survived. All patients were followed up 6-30 months (mean, 15.8 months). The ALT perforator flaps had good appearance and color, with no further flap revision or defatting procedures. The static two-point discrimination was 8-15 mm (mean, 10.5 mm). All patients could walk and run normally without postoperative skin erosions or ulcerations. Conclusion The free thinned innervated ALT perforator flap is pliable and thin. It is suitable for repairing the donor site defects after wrap-around flap transfer for thumb reconstruction.

    Release date:2017-08-03 03:46 Export PDF Favorites Scan
  • RECONSTRUCTION OF THUMB BY VASCULARIZED SECOND METATARSO-PHALANGEAL JOINT AND BIG-TOE NAIL COMPOSITE GRAFT

    Since Oct. 1990, the 2nd metatarso-phalangeal joint and big-toe nail composite graft with the neuro-vascular bundle was transplanted to reconstruct the thumb in 4 cases. The transplants were all survived. The follow-up through 5 months, a comparatively good function and appearance were achieved.The applied anatomy, the surgical technique and the matters needing attention were detailed.

    Release date:2016-09-01 11:38 Export PDF Favorites Scan
  • 游离桡侧副动脉嵌合穿支皮瓣修复踇甲瓣供区复合组织缺损

    目的总结游离桡侧副动脉嵌合穿支皮瓣移植修复踇甲瓣供区复合组织缺损的疗效。方法2020年4月—2021年3月,采用游离桡侧副动脉嵌合穿支皮瓣修复7例踇甲瓣切取后遗留的复合组织缺损。男3例,女4例;年龄7~44岁,中位年龄20岁。踇甲瓣切取后,遗留皮肤软组织缺损范围为5 cm×2 cm~9 cm×6 cm;均合并大小为1.5 cm×1.0 cm~3.0 cm×1.0 cm的骨缺损。采用游离桡侧副动脉嵌合穿支皮瓣修复创面,皮瓣切取范围为6.0 cm×2.5 cm~10.0 cm×5.0 cm;均携带肱骨瓣修复骨缺损、臂后侧皮神经重建感觉。上臂供区创面直接闭合。结果 术后7例皮瓣均顺利成活,创面Ⅰ期愈合。患者均获随访,随访时间7~15个月,平均14个月。桡侧副动脉嵌合穿支皮瓣无臃肿,颜色、质地与足背部皮肤接近;肱骨瓣均愈合。末次随访时,6例皮瓣两点辨别觉为6~10 mm,平均7.5 mm;1例恢复保护性感觉。上臂皮瓣供区仅留线性瘢痕。结论 游离桡侧副动脉嵌合穿支皮瓣可同时携带骨瓣及皮神经,修复踇甲瓣切取后遗留的复合组织缺损。

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