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1、臨床小兒外科雜志2014年10月第13卷第5期JournalofClinicalPediatricSurgery,October2014,Vol.13,No.5·432··臨床研究·小兒同指順行指動脈神經(jīng)蒂皮瓣修復(fù)指端(腹)缺損46例111211薛俊紅陳惠敏張艷敏范華波李強陳月【摘要】目的總結(jié)小兒同指順行指動脈神經(jīng)蒂皮瓣修復(fù)指端(腹)缺損的臨床應(yīng)用及療效。方法2009年1月至2012年12月我們對46例小兒指端(腹)缺損的患兒應(yīng)用同指順行指動脈神經(jīng)蒂皮瓣進行修復(fù),其中25例切取時保留甲床神經(jīng)分支。46例中,指端缺損24例,指腹缺損22例,皮膚缺損面積0.5cm×
2、1.0cm~0.8cm×1.0cm。年齡2~11歲,平均年齡5.8歲。結(jié)果皮瓣全部成活,無動靜脈危象發(fā)生。選擇保留和不保留甲床神經(jīng)分支病例各10例,經(jīng)1~3年隨訪,皮瓣外形飽滿,色澤、出汗正常,供受區(qū)僅有線樣瘢痕。16例甲床者指甲發(fā)育正常,無甲板分離及勾甲畸形,4例出現(xiàn)輕度甲縱脊或橫紋。兩點辨別覺正常,精細觸覺恢復(fù),手指無活動障礙。結(jié)論在嚴格掌握適應(yīng)證的前提下,同指順行指動脈神經(jīng)蒂皮瓣是修復(fù)小兒指端(腹)缺損的良好方法?!娟P(guān)鍵詞】指;外科皮瓣;修復(fù)外科手術(shù);兒童Byanterogradedigitalarteryflapfromthesamefingertore
3、pairdigittipinjuryandpulplossofchildren.XUEJunhong,CHENHuimin,ZHANGYanmin,etal.【Abstract】ObjetiveToreporttheeffectandclinicalapplicationsofusingantegradedigitalarteryflapsfromthesamefingertorepairdigitinjuryandpulploss.MethodsFromJanuary2009toDecember2012.46casesofthedigitfingert
4、ipinjuryandfingerpulpdefectweretreatedwithanterogradedigitalarteryflapstransferformthesamefinger,therewere25casesofthemwhichpreservenailbed.therewere24casesoffingertipinguryand31casesofpulpdefect.Thedefectscopeswere0.5cm×1.0cmto0.8cm×1.0cmtheagerangedfrom2to11years,theaverageagewas5
5、.8years.ResultsAllflapssurvivedafteroperation,therewasnovascularcrisis.10caseswithnailbedand10caseswithoutnailbedwhichwerefollowedupfrom1to3years.Theflapshadgoodappearanceandtextureandsweat,herewerejustfewstringsignonthedonorandreceientsites.Thenailsof16caseswhichpreservenailbedgrewn
6、ormallywithoutnailbedpartialandnaildeformity,4casesoftheyhavelongitudinalridgeornailstripes.Twopointdiscriminationwerenormal.finetouchandfunctionoffingermotionwereobtained.ConclusionWhentheindicationundercontrolitisabettermethodforrepairoffingertipdefectandfingerpulplossbythedigital
7、neurovascularantegradeflapsfromthesamefinger.【Keywords】Fingers;SurgicalFlaps;ReconstructiveSurgicalProcedures;Child小兒指端(腹)外傷缺損臨床較常見,處理棘一、臨床資料手。傳統(tǒng)的指端缺損修復(fù)方法在處理小兒指端本組46例55指,其中男28例,女18例。傷(腹)外傷缺損時受到明顯限制。我們應(yīng)用同指順情:壓砸傷11例,擠壓傷23例,切割傷12例。指行指動脈神經(jīng)蒂皮瓣對46例小兒指端(腹)缺損的別:拇指8指,示指19指,中指18例,環(huán)指6例,小病例進行修復(fù),
8、療效滿意。指4例。年齡2