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find Keyword "手指末节脱套伤" 3 results
  • REPAIRING DEGLOVING INJURY OF DISTAL PHALANX WITH HOMODIGITAL BILOBED FLAPS TILED

    Objective To study the methods and effectiveness of repairing degloving injury of the distal phalanx with homodigital bilobed flaps tiled. Methods Between April 2008 and June 2011, 40 patients (40 fingers) with degloving injury of the distal phalanx were treated, which were caused by machine. There were 30 males and 10 females, aged from 18 to 56 years(mean, 30 years). The time from injury to operation was 1-5 hours (mean, 2.5 hours). Affected fingers included index in 13cases, middle finger in 11 cases, ring finger in 9 cases, and l ittle finger in 7 cases. The defect area ranged from 3.0 cm × 2.0 cm to 5.5 cm × 3.8 cm. All cases complicated by pollution and exposure of tendon and phalanx, 5 cases by phalangeal fractures, and tendon insertion had no rupture. The end dorsal branches of digital artery island flaps and digital arterial island flaps were used in 14 cases, the end dorsal branches of digital artery island flaps and near dorsal branches of digital artery island flaps in 18 cases, and the end dorsal branches of digital artery island flaps and superficial palmar digital veins arteril ization island flaps in 8 cases. The area of the upper flaps ranged from 2.0 cm × 1.5 cm to 2.6 cm × 2.2 cm and the area of the next leaf flaps ranged from 2.5 cm × 2.0 cm to 3.5 cm × 2.5 cm. The donor sites were covered with free flaps. Results Flap bl ister occurred in 13 cases and vascular crisis in 3 cases. The flaps survived in 40 cases, wound healing by first intention was achieved in 38 cases, and by second intention in 2 cases. The donor skin-grafting was survival. After operation, 30 patients were followed up 8 to 20 months with an average of 10.6 months. The flaps had satisfactory appearance and soft texture, and the finger tip had no touch pain. The sensory function of the flaps was restored at 4-6 weeks after operation; two-point discrimination was 6.0 to 10.0 mm in 24 flaps at 12-15 months. According to the total active movement (TAM) evaluation system introduced by the American Society for Surgery of the Hand in 1975, the results were excellent in 27 cases, good in 2 cases, and fair in 1 case, and the excellent and goodrate was 96.7%. Conclusion The homodigital bilobed flaps tiled for degloving injury of the distal phalanx is simple and easyto- operate with less injury.

    Release date:2016-08-31 04:23 Export PDF Favorites Scan
  • 游离尺动脉近中段穿支蒂M形皮瓣修复手指末节脱套伤

    目的探讨游离尺动脉近中段穿支蒂M形皮瓣修复手指末节脱套伤的疗效。 方法2012年3月-2013年3月,收治9例手指末节脱套伤患者。男7例,女2例;年龄18~68岁,平均38岁。致伤原因:冲压伤5例,机器绞轧伤4例。损伤指别:示指4例,中指3例,环指2例。合并末节指骨骨折1例,伸肌腱止点断裂1例。伤后至手术时间为3~8 h,平均4.6 h。采用大小为6.5 cm×1.8 cm~6.8 cm×2.2 cm的前臂尺侧游离尺动脉近中段穿支蒂M形皮瓣修复缺损,供区创面直接缝合。 结果术后1例背侧皮瓣发生张力性水疱,对症处理后成活;其余皮瓣均顺利成活,创面Ⅰ期愈合。术后9例均获随访,随访时间6~17个月,平均12个月。除1例发生张力性水疱者皮瓣色素沉着较明显外,其余皮瓣外形、质地均良好;末次随访时皮瓣两点辨别觉为7~12 mm,平均9 mm;参照中华医学会手外科学会上肢部分功能评定试用标准评价手指功能:获优8例,良1例。 结论尺动脉近中段穿支解剖较为恒定,利用穿支蒂M形皮瓣修复手指末节脱套伤,不牺牲主干血管,手术操作简便,疗效满意。

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  • 双侧指动脉神经束残端蒂皮瓣瓦合修复手指末节脱套伤

    目的总结双侧指动脉神经束残端蒂皮瓣瓦合修复手指末节脱套伤疗效。 方法2013年6月-2014年12月,采用双侧指动脉神经束残端蒂皮瓣瓦合修复手指末节脱套伤11例。男8例,女3例;年龄23~ 47岁,平均30岁。致伤原因:绞伤4例,压榨伤7例。损伤指别:示指4例,中指5例,环指2例。皮肤软组织脱套平面均在远指间关节以远。皮肤缺损范围3.0 cm×3.0 cm~5.0 cm×3.5 cm。受伤至手术时间4~12 h,平均7 h。皮瓣切取范围为1.5 cm×1.5 cm ~?2.5 cm×1.5 cm。供区游离植皮修复。 结果术后皮瓣及植皮均成活,创面Ⅰ期愈合。患者均获随访,随访时间6~10个月,平均7个月。皮瓣质地柔软、色泽满意,指端饱满、不臃肿。术后2周皮瓣两点辨别觉为5~10 mm,平均7 mm。术后6个月根据中华医学会手外科学会上肢部分功能评定试用标准,获优9例,良2例,优良率100%。 结论采用双侧指动脉神经束残端蒂皮瓣瓦合修复手指末节脱套伤具有操作简便、手术创伤小等优点,术后手部外观及功能恢复满意。

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