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find Keyword "指端脱套伤" 3 results
  • 指动脉串联逆行岛状皮瓣修复老年指端脱套伤

    目的总结指动脉串联逆行岛状皮瓣修复老年指端脱套伤的疗效。 方法2011年6月-2012年8月,收治7例老年指端脱套伤。男5例,女2例;年龄56~68岁,平均62岁。致伤原因:冲压伤4例,机器绞伤3例。损伤指别:示指3例,中指3例,环指1例。合并末节指骨骨折2例,伸肌腱止点撕脱1例,相邻指损伤1例。伤后至手术时间为3~5 d,平均3.6 d。术中在患指切取近节指根部及掌远端2块皮瓣瓦合修复指端皮肤软组织缺损;近节指根部侧方皮瓣切取范围为1.4 cm × 1.2 cm~2.0 cm × 1.8 cm,掌远端皮瓣为1.1 cm × 1.0 cm~1.8 cm × 1.5 cm。掌远端供区直接缝合,指根部供区游离植皮修复。 结果1例掌远端皮瓣术后12 h发生静脉危象,经间断拆线后缓解;其余皮瓣及供区植皮均顺利成活,创面Ⅰ期愈合。术后7例均获随访,随访时间6~20个月,平均12个月。皮瓣外形、质地均良好。末次随访时,近节指根部侧方皮瓣两点辨别觉为7~10 mm,掌远端皮瓣为8~12 mm;手指功能参照中华医学会手外科学会上肢部分功能评定试用标准:获优6例,良1例。 结论指动脉串联逆行岛状皮瓣是利用远侧指间关节指固有动脉交通支的解剖特点,将相邻的2块皮瓣瓦合修复老年患者指端脱套伤,手术操作简便,疗效满意。

    Release date:2016-08-31 04:05 Export PDF Favorites Scan
  • REVERSE ISLAND FLAP OF DIGITAL ARTERY PARALLEL FOR REPAIRING DEGLOVED INJURIES OF FINGERTIP

    Objective To investigate the effectiveness of reverse island flaps of digital artery parallel for repairing degloved injuries of the fingerti p. Methods Between June 2008 and January 2010, 13 cases of degloved injuries of the fingertip were treated. There were 8 males and 5 females with an average age of 34 years (range, 19-62 years). The causes of injuries were as follow: impact and press injury in 5 cases, wringer injury in 7 cases, and crush injury in 1 case. The injured fingers were comprised of index finger in 6 cases, middle finger in 4 cases, ring finger in 2 cases, and l ittle finger in 1 case. The size of skin and soft tissue defect ranged from 2.0 cm × 1.8 cm to 3.0 cm × 2.5 cm. Three cases compl icated by fracture of thedistal phalanx, 1 case by rupture of the insertion of extensor tendon, and 1 case by rupture of the insertion of flexor tendon. The average time from injure to surgery was 4 hours (range, 1 hour and 30 minutes-12 hours). Two neighboring skin flaps located in the same course of digital artery were adopted to repair defect of the fingertip. The size of proximal skin flap ranged from 1.2 cm × 1.0 cm to 2.0 cm × 1.5 cm and the size of distal skin flap ranged from 1.1 cm × 1.0 cm to 1.5 cm × 1.3 cm. The free skin grafts were used to repair the donor sites. Results Circulation crisis occurred in 1 case at 2 hours after operation and was el iminated by interval disconnecting. The other flaps and skin grafts survived and the wounds healed by first intention. The patients were followed up 6-18 months (mean, 10 months). All flaps presented the satisfactory appearance and texture, and the flexion and extension function of wounded fingers recovered to normal. Two-point discrimination ranged from 7 to 11 mm at last follow-up. According to the functional assessment criteria of upper l imb formulated by the Hand Surgery Branch of Chinese Medical Association, the results were excellent in 9 cases, good in 3 cases, and fair in 1 case with an excellent and good rate of 92.3%. Conclusion Based on the anatomical features of communicating branches of distal interphalangeal joint, two neighboring flaps located in the same course of digital artery are adopted to repair soft tissue defect of the fingertip. This surgical method is a simple and effective method.

    Release date:2016-08-31 05:45 Export PDF Favorites Scan
  • 同指指动脉背侧皮支血管链皮瓣逆行修复手指指端脱套伤

    目的探讨同指指动脉背侧皮支血管链皮瓣逆行修复手指指端脱套伤的疗效。方法2015 年 9 月—2017 年 2 月,收治 25 例(25 指)第 2~5 指指端脱套伤患者。男 16 例,女 9 例;年龄 20~63 岁,平均 38 岁。致伤原因:机器绞伤 12 例,挤压伤 8 例,重物砸伤 5 例。受伤至手术时间为 2.0~5.5 h,平均 4.0 h。指端创面范围为 2.0 cm×1.8 cm~4.0 cm×2.3 cm。采用大小为 2.2 cm×2.0 cm~4.4 cm×2.5 cm 的同指指动脉背侧皮支血管链皮瓣修复创面,皮瓣携带的指固有神经背侧支及指背神经与创面内双侧指固有神经残端吻合。供区游离植皮。结果术后 2 例皮瓣出现静脉回流障碍,对症处理后成活;其余皮瓣以及全部供区植皮均顺利成活。患者均获随访,随访时间 10~18 个月,平均 15 个月。皮瓣外形、颜色、质地良好,末次随访时皮瓣静态两点辨别觉为 5~9 mm,平均 6.9 mm。伤指功能参照中华医学会手外科学会上肢部分功能评定试用标准,获优 17 例、良 7 例、可 1 例。结论采用同指指动脉背侧皮支血管链皮瓣逆行修复指端脱套伤,操作简便、供区损伤小,疗效满意。

    Release date:2020-06-15 02:43 Export PDF Favorites Scan
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