拇指末端指腹缺损的分型与处理

袁锋 俞光荣 蔡宣松 2005-12-13 13:20:42 中华实用医药杂志 2003年6月第3卷第11期

【摘要】 目的 探讨拇指末端指腹缺损修复的最佳治疗方案及其疗效。方法 依据伤情对163例拇指末端指腹缺损进行临床分型:分2型，4个亚型，并依据拇指末端指腹缺损的分型分别进行植皮、V-Y皮瓣、指掌侧推进皮瓣、带血管神经蒂岛状皮瓣、游离皮瓣不同方法修复。结果 119例于手术后1～4.5年（平均1.75年）获得随访，不同的临床分型与不同修复方法有一定的相关性。结论 有骨外露的Ⅰb、Ⅱb型缺损以带血管神经蒂岛状皮瓣和游离皮瓣修复较好，恢复较为满意;而Ⅰa、Ⅱa型缺损以植皮为好，远期效果基本满意。

关键词 拇指 末端指腹缺损 分型

Classification and treatment of skin defect of the thumb in distal belly-finger

 Yuan Feng，Yu Guangrong，Cai Xuansong 

Dept.of Orthopaedics，Tongji Hospital Affiliated to Shanghai Tongji University，Shanghai200065. 

【Abstract】 Objective To study the best effect of reconstruction of skin defect of the thumb in distal belly-finger.Methods 163cases of skin defect of the thumb in distal belly-finger can be divided into two types and four groups（Ⅰa，Ⅰb，Ⅱa，Ⅱb）and were reconstructed by skin graft，V-Y flap，belly-finger advancement of skin flap，vascular pedicled island and minimal free flap.Results 119cases were followed for1～4.5years.There were some relation between differet types and reconstruction.Conclusion It is good for the typeⅠb andⅡb to be reconstructˉed by flap graft，and the typeⅠa andⅡa to be reconstructed by skin graft.The external appearance and function was satisfactory.

Key words thumb distal belly-finger skin defect typing