严重手指伴手掌部分缺失的修复重建.pdfVIP

• 212 • 中华手外科杂志2015 年6 月第 31 卷第 3 期 Chín J H皿dSur茧， J\llle 2015 ,Vo1. 31 ,No. 3 ·论著· 严重于指伴手掌部分缺失的修复重建 刘勇张成进付兴茂王金IJ 利隋志强张雪涛王蕾 [摘要] 目的 探讨应用足趾联合肩H甲骨皮瓣进行手指伴手掌部分缺失修复重建的临床效 果。方法 切取肩I甲骨皮瓣重建缺失手掌，切取双足 2 至4 个足趾进行手指再造，一期完成子的修 复重建。 2010 年6 月至 2013 年3 月对8 例严重手指伴于掌部分缺失的患者同用该方法进行手的修 复重建。结果 8 例子修复重建全部存活。其中 l 例术后第 1 天发生血管危象，经重新探查吻合血 管后存活。术后随访时间为 6- 12 个月，手外形及功能恢复良好，按手指功能损害程度的综合评定， 全部手功能由术前的 10%上升到术后的 60% ，功能平均增加 50% ，极大地改善了子的功能。结论 应用足趾联合肩脚骨皮瓣进行手指伴手掌部分缺失的修复重建是一种较好的方法。 [关键词] 外科皮瓣; 移植; 组织瓣; 于修复重建 R优创JStmction of severely mu位lated 曲JgersalωJg with 阴rtial 阳1m defect μu Yo臂， Zhang Chengjin , Fu Xi咆刑剧， Wang Jianli , Sui ZIμ， qiang , Zhang Xue.脚， Wa.r引g l.ei. The Trauma1ic Cen1re 89th H.ο酬的1 of PIA , Weifa.r喀 261021 , China [Abstract 1 0均创刊 To investigate the clini叫 outcomes of re∞nstruct吨 fingers and partial palm defect 白th combined transfer of toes anrl f;C apula osleocutaneous 丑ap. Methods The scapula osleocutaneous flap w描 Iransferred 10 reconstrucl the rnissing part of the palm of 由e hand. Depending on 由e number of finge自 由al were rnissing , 2 10 4 Lues were harvested from both feel and transferred 10 reconstrucl the fingers simultaneously. From June 2010 to March 2013 a 10凶。，[ 8 c坦白 of severely mutilated hand were reconstructed by Ihis method. Results All the transplants in the 8 cases survived completely. V描cul缸 crisis occurred within the first 12 hours postoperatively in 1 c皿e. Sm苦ical exploration and re-anastomosis of the vessel solved the crisis and led 10 transplant survival. Posloperative follow-up ranged from 6 to 12 months. Appearance and function of 出e reconstructed hands were !ii旺赳. COIIlprehensive evaluation of hand function based on severity of the defects indicated an improvement of whole hand function from 10%ω60% ， an average increase of 50% . Conclusion