【摘要】 目的解决第二趾趾甲瓣在修复手指皮肤套脱伤时,因第二趾短、细,造成手指侧方及根部皮肤难以覆盖的问题。方法对5例6指皮肤套脱伤患者,根据指背、掌侧及两侧皮肤缺损的长度,设计带翼状皮瓣的第二趾趾甲瓣。手指掌侧皮肤缺损,由第二趾跖侧皮肤覆盖,一般设计与趾根同宽；第二趾腓侧因切开后套人粗大的手指后造成的皮肤缺损由第三趾胫侧趾动脉皮瓣覆盖,第二趾胫侧趾根部缺损由蹲趾腓侧趾动脉皮瓣覆盖,其余创面长度及宽度的不足由跖背皮瓣覆盖。结果术后趾甲瓣全部存活。随访3～6个月,手指屈伸功能及外形恢复满意,手指皮肤两点分辨觉为5～9mm。结论采用带翼状皮瓣的第二趾趾甲瓣修复手指套脱伤,方法可靠,疗效满意。更多还原

【Abstract】 Objective To provide a method of overcoming the-difficulty of covering the skin defect remained at the side and base of the finger after repair with wrap-around flap from the second toe for finger avulsion injuries. Methods Based on the size of the defect area,second toe wrap-around flap combined with dorsalis pedis flap were designed to cover the tip,palm and dorsal aspects of the avulsed finger.A digital vascular flap from the tibial side of the third toe was designed to cover the exposed area in adjacent side of the second toe wrap-around flap which was cut open to accommodate the finger.Another digital vascular flap from the fibular side of the great toe was designed to cover the remaining area at the base of the injured finger.These four flaps were joined at the web space,and all of them were supplied by the same vessel—the first dorsal metatarsal artery.In this way,the two digital vascular island flaps from adjacent toes linked with the second toe wrap-around flap like two wings.Results In 5 patients with avulsed injuries of 6 fingers,coverage was obtained using the second toe wrap-around flap with wings.All flaps survived.Follow-up ranged from 3 to 6 months.The outcome was satisfactory both functionally and cosmetically.2-PD was 5-9 mm. Conclusions Second toe wrap-around flap with two wings from adjacent toes has the following advantages for treatment of finger avulsion injuries.1.Coverage and be accomplished in one operation without the worry about the size of skin defect.2.A relatively simpler operation is achieved.3.Sufficient blood supply is provided through the constant vessels.Its disadvantage includes relatively bigger donor-site morbidity.更多还原