Composite dorsal flap for composite tissue defect of hand-back.docVIP

 PAGE \* MERGEFORMAT 9 Composite dorsal flap for composite tissue defect of hand-back Study: Fan Ling, Pan Xianming, the right to Yi, Huang Gang, Li Wei [Keywords:] back of the hand skin; tendon defect; repair Traumatic dorsal skin, tendon defects are not uncommon, if not properly handled will result in hand with severe dysfunction .1999 to 2006, with the use of our department and the extensor digitorum tendon dorsal cutaneous nerve of the hand of the free composite flap of skin and tendon defect 7 cases, satisfactory appearance and function, reported as follows. 1 Materials and Methods 1.1 General Information The group of 7 patients, 5 males and 2 females; aged 18 to 49 years, mean age 31 years; twist contusion in 3 cases, 3 cases of avulsion, burns in 1. Flap maximum 16. 5cm 8cm, minimum 8cm 4cm; 4 of which were four extensor tendon defects, 2 cases of extensor tendon defect 3, 1 2 extensor tendon defects. 2 to 10 hours after injury, four cases of emergency surgery, elective surgery in 3 patients. 1.2 surgical methods (1) by Region: debridement of the injured limb or the removal of scar, keeping viable periosteum and find remnants of the tendon stump and measured defect length. In his early separation of the wrist snuff fossa vein, radial artery and its concomitant vein and superficial branch of radial nerve. (2) for the area: in the ipsilateral dorsal artery and marked with gentian violet saphenous vein out of shape to take shape as the dorsalis pedis artery flap axis line, according to hand back the flap of skin defect area cut the scope of the design, area by area increased more than 2cm, the remote up to toe web, the proximal extensor bring up the sides of the first metatarsal and outside edge 1,5. Paper flap cut from the remote start, cut off the toe as needed and keep a complete extensor tendon aponeurosis, the long toe extensor tendon residual digitorum brevis tendon and distal anastomosis. 1 1 gap plantar metatarsal artery and dors