宫旭 路来金 杨涛 于家傲 朴成东 130021 长春，白求恩医科大学第一临床学院手外科 中华手外科杂志 1999 0 15 4


    关键词：Kienbock病；头状骨短缩术；应力应变 期刊 zhswkzz 0 月骨无菌性坏死 fur -->


    

【摘要】 目的 介绍第二掌背动脉肌腱皮瓣修复手指皮肤伴肌腱缺损的应用价值。方法 在解剖学研究的基础上,采用第二掌背动脉肌腱皮瓣修复手指皮肤伴肌腱缺损11例。其中,伴屈肌腱缺损3 例,伸肌腱缺损8例。 皮瓣顺行移位3例,逆行移位4例,游离移植4例。结果 10例肌腱皮瓣移植后完全成活,1例部分坏死，经换药后伤口愈合。8例术后随访12 ～ 57个月，3例失访。 两点辨别觉:手指背侧8 ～ 11 mm，指腹5～ 7 mm。 手指伸屈功能均恢复至健侧的60 % ～ 70 %。 结论 第二掌背动脉肌腱皮瓣是修复手指或手部小范围皮肤伴肌腱缺损的理想皮瓣。

    

Clinicalapplication of the second dorsal metacarpal artery flap with the extensor index propertendon

YU Guangrong, YUAN Feng. Department of Orthopedics, Ganquan Hospital, Medical College of Shanghai RailwayUniversity, Shanghai 200065

【Abstract】 Objective Tointroduce the procedure for repair of skin and tendon defect in the fingers using thesecond dorsal metacarpal artery flap with the extensor index proper tendon, and evaluateits clinical application. Methods Elevencases of skin and tendon defect in the fingers were treated by transfer of the seconddorsal metacarpal artery flap with the extensor index proper tendon. There were 3 cases offlexor tendon defect and 8 cases of extensor tendon defect. The skin and tendon defect wasrepaired by antegrade transfer of the composite flap in 3 cases, retrograde transfer ofthe flap in 4 cases, and free transplantation of the flap in 4 cases. Results The flaps survived in 10 cases and had partial necrosis in 1case which achieved secondary healing after dress changing. 8 cases were followed up for12 to 57 months. The two - point discrimination was 8 to 11 mm at the dorsum of thefingers and 5 to 7 mm in the finger pulp. The range of motion of finger extension andflexion was 60 % ～ 70 % of that of the unaffectedfingers. Conclusions The seconddorsal metacarpal artery flap with the extensor index proper tendon is an ideal flap forrepair of small skin defect combined with tendon defect in the fingers or in the hand.

     ......