以近、中节为供区的指动脉背侧支血管链皮瓣修复同指指端缺损对比研究

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摘要目的分析并比较以近、中节为供区的指动脉背侧支血管链皮瓣修复同指指端缺损的效果。方法回顾性分析2016年2月至2020年8月唐山市第二医院收治48例(48指)第2~5指指端缺损急诊入院患者，分别采用近节指动脉背侧支血管链皮瓣修复26例(26指)，其中男17例，女9例；年龄18~55岁，平均(36.5±10.9)岁；中节指动脉背侧支血管链皮瓣修复22例(22指)，其中男14例，女8例；年龄20~54岁，平均(35.8±10.7)岁。比较两组患者年龄、性别、创面大小、手术时间、随访时间、皮瓣外观满意度、皮瓣静态两点辨别觉、伤指关节总活动度及术后供区外观等情况。结果术后两组皮瓣均顺利存活。随访时间12~20个月。两组患者年龄、性别、创面大小、手术时间、随访时间及伤指关节总活动度比较差异无统计学意义(P＞0.05)。两组患者皮瓣外观满意度、静态两点辨别觉、供区术后外观比较，中节组优于近节组，差异有统计学意义(P＜0.05)。结论以近、中节皮肤为供区的指动脉背侧支血管链皮瓣，术式简单、血供可靠，适合修复同指指端软组织缺损。相对近节供区皮瓣，以中节为供区的指动脉背侧支血管链皮瓣外形更美观、供区瘢痕小、术后感觉恢复更佳。

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	贾鑫玮
	王辉
	曹惠荣
	王红涛
	张一晗
	邓凯
	王志强

关键词 ：外科皮瓣, 手指损伤, 指端缺损, 指动脉背侧支皮瓣

Abstract：Objective To analyze and compare the effect of dorsal branch chain flaps of digital artery with proximal and middle segments as donor sites in repairing fingertip defects of the homodigital finger.Methods A retrospective analysis was performed on 48 patients (48 fingers) with defects of the 2nd to 5th fingertips admitted to the Second Hospital of Tangshan from February 2016 to August 2020.Dorsal branch chain of proximal phalangic artery flaps were used in 26 fingers of 26 cases，including 17 males and 9 females.The age ranged from 18 to 55 years，with a mean ago of (36.5±10.9) years.Dorsal branch chain of middle knuckle finger artery flaps were used in 22 fingers of 22 cases，including 14 males and 8 females.The age ranged from 20 to 54 years，with a mean ago of (35.8±10.7) years.Age，gender，wound size，operation time，follow-up time，skin flap appearance satisfaction，static two-point discrimination，total range of motion of injured knuckles and postoperative donor site appearance were compared between the two groups.Results All flaps survived successfully after operation.The follow-up time was 12 to 20 months.There were no significant differences in age，sex，wound size，operation time，follow-up time and total range of motion of injured digits between the two groups (P＞0.05).The satisfaction of flap appearance，static two-point discrimination，and postoperative appearance of donor site of patients in the middle segment donor site group were better than those in the near segment donor site group，and the differences were statistically significant (P＜0.05).Conclusion The dorsal branch-chain flaps of digital artery with the skin of the proximal and middle segments as the donor site is a simple operation with reliable blood supply.It is suitable for repairing soft tissue defects of the homodigital fingertip.Compared with the proximal donor site flap，the dorsal branch-chain flaps of digital artery with the middle segment as the donor site has more beautiful in appearance，less scar in the donor site，and better postoperative sensory recovery.

Key words： surgical flap digital injury fingertip defect dorsal branch of digital artery flap

基金资助:河北省医学科学研究课题计划项目(20201453)
河北省医学适用技术跟踪项目(GZ2021030)
唐山市市级科技计划项目(22150219J)

通讯作者: 王志强

作者简介: 贾鑫玮(1996－ )，男，医师，华北理工大学附属医院骨科，jiaxinwei0228@qq.com

引用本文:

贾鑫玮，王辉，曹惠荣，王红涛，张一晗，邓凯，王志强. 以近、中节为供区的指动脉背侧支血管链皮瓣修复同指指端缺损对比研究[J]. 实用骨科杂志, 2023, 29(01): 14-.
Jia Xinwei，Wang Hui，Cao Huirong，Wang Hongtao，Zhang Yihan，Deng Kai，Wang Zhiqiang. Comparative Study of Dorsal Branch Chain Flaps of Digital Artery with Proximal and Middle Segments As Donor Sites in Repairing the Homodigital Fingertip Defects. sygkzz, 2023, 29(01): 14-.

链接本文:

http://www.sygkzz.com/CN/ 或 http://www.sygkzz.com/CN/Y2023/V29/I01/14

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