中国修复重建外科杂志

中国修复重建外科杂志

以鰒趾腓侧趾背动脉供血的鰒趾甲床瓣修复手指甲床中央纵形缺损

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目的探讨以ル趾腓侧趾背动脉供血的ル趾甲床瓣修复手指甲床中央纵形缺损的方法及临床疗效。方法2012 年 5 月—2017 年 2 月,应用以ル趾腓侧趾背动脉供血的ル趾甲床瓣修复手指甲床中央纵形缺损 7 例(7 指)。男 3 例,女 4 例;年龄 17~35 岁,平均 27 岁。致伤原因:切割伤 2 例,电刨伤 3 例,摩擦伤 2 例。损伤指别:拇指 3 例,示指 3 例,中指 1 例。缺损范围 12 mm×8 mm~21 mm×13 mm。受伤至入院时间为 1~2 h,平均 1.5 h。甲床瓣切取范围 14 mm×10 mm~23 mm×15 mm。供区直接缝合 3 例,游离植皮修复 4 例。结果术后甲床瓣及供区植皮均顺利成活,创面均Ⅰ期愈合。患者均获随访,随访时间 9~36 个月,平均 23 个月。拇、手指指甲生长平整、有光泽、外形饱满。术后 9 个月测量甲床瓣皮肤两点辨别觉为 7~9 mm,平均 8 mm。参照 Zook 等甲床修复评定标准:获优 6 例、良 1 例,优良率达 100%。结论以ル趾腓侧趾背动脉供血的ル趾甲床瓣修复手指甲床中央纵形缺损可获得较好疗效。

ObjectiveTo explore the surgical method and effectiveness of the great toenail bed flap supplied with the fibular dorsal artery of great toe in repair of the finger nail bed central longitudinal defect.MethodsBetween May 2012 and February 2017, 7 cases (7 fingers) with the finger nail bed central longitudinal defects were repaired with the great toenail bed flap supplied with the fibular dorsal artery of great toe. There were 3 males and 4 females; the age ranged from 17 to 35 years (mean, 27 years). The cause of injury included cutting injury in 2 cases, electric shaving injury in 3 cases, and frictional injury in 2 cases. The defect located at thumb in 3 cases, index finger in 3 cases, and middle finger in 1 case. The defect area ranged from 12 mm×8 mm to 21 mm×13 mm. The time from injury to admission was 1-2 hours (mean, 1.5 hours). The area of the great toenail bed flap ranged from 14 mm×10 mm to 23 mm×15 mm. The wound of donor site was directly sutured in 3 cases and repaired with full thickness skin graft in 4 cases.ResultsAll the great toenail bed flaps and skin grafts at the donor sites survived; and all wounds healed by first intention. All patients were followed up 9 to 36 months (mean, 23 months). The finger nails were smooth and shiny and recovered ideal appearance. At 9 months after operation, the two-point discrimination of the skin ranged from 7 to 9 mm (mean, 8 mm). According to the standard evaluation for nail bed repair issued by Zook etc., 6 cases were rated as excellent and 1 case as good, and the excellent and good rate was 100%.ConclusionIt is an ideal method to repair the finger nail bed central longitudinal defect with the great toenail bed flap supplied with the fibular dorsal artery of the great toe.

关键词: ル趾; 趾背动脉; 甲床瓣; 甲床损伤; 创面修复

Key words: Great toe; dorsal artery of great toe; nail bed flap; nail bed injury; wound repair

引用本文: 刘铭波, 毕莹, 李娜, 叶伟德, 李保龙, 杨延军, 张子清. 以鰒趾腓侧趾背动脉供血的鰒趾甲床瓣修复手指甲床中央纵形缺损. 中国修复重建外科杂志, 2019, 33(3): 345-348. doi: 10.7507/1002-1892.201810081 复制

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