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find Keyword "趾腓侧皮瓣" 6 results
  • (足母)趾腓侧皮瓣游离移植修复手指掌侧皮肤缺损

    目的 总结(足母)趾腓侧皮瓣游离移植修复手指掌侧皮肤缺损的疗效。 方法 2005 年7 月-2009 年9 月,收治手指掌侧皮肤缺损20 例。男16 例,女4 例;年龄18 ~ 56 岁,平均28.5 岁。致伤原因:机器绞伤12 例,爆炸伤5 例,感染引起局部坏死3 例。拇指14 例,示指3 例,中指3 例。17 例外伤创面有不同程度污染,伤后至入院时间为1 ~ 6 h;3 例感染创面发生局部皮肤坏死,伤后至该次入院时间为15 ~ 53 d。创面缺损范围3.0 cm × 2.0 cm ~ 3.5 cm × 2.5 cm。术中采用大小为3.5 cm × 2.5 cm ~ 4.0 cm × 3.0 cm 的(足母)趾腓侧皮瓣游离移植修复创面,供区植皮修复。 结果 1 例术后2 d 因动脉危象导致皮瓣坏死,行邻指指固有动脉侧方皮瓣移位修复后成活;其余皮瓣及植皮均顺利成活,创面均Ⅰ期愈合。术后19 例获随访,随访时间6 ~ 18 个月,平均12 个月。手指外形、质地较好。末次随访时示、中指掌指关节屈曲达80 ~ 90°,近侧指间关节屈曲达80 ~ 100°,远侧指间关节屈曲达20 ~ 30°;拇指指间关节屈曲30 ~ 80°;对指、对掌功能不受限。供足行走正常。 结论 (足母)趾腓侧皮瓣游离移植修复手指掌侧皮肤缺损具有质地结构相似、精细感觉恢复优良、不需二次整形等优点,是有效治疗方法之一。

    Release date:2016-08-31 05:43 Export PDF Favorites Scan
  • 急诊足母趾腓侧皮瓣嵌入塑形第2 足趾移植拇指再造

    目的 总结在急诊第2 足趾移植拇指再造术中,应用趾腓侧皮瓣嵌入塑形的临床经验。 方法 1998 年1 月- 2003 年1 月,急诊应用带趾腓侧皮瓣嵌入塑形的第2 足趾移植再造外伤性拇指缺损12 例,男9 例,女3 例;年龄23 ~ 45 岁。撕脱伤5 例,压砸伤7 例。缺损程度:Ⅲ度5 例,Ⅳ度1 例(清创后为Ⅴ度缺损),Ⅴ度6 例。伤后至手术时间2 ~ 7 h,平均5.4 h。术中切取趾腓侧皮瓣范围1.5 cm × 0.5 cm ~ 2.0 cm × 0.8 cm。趾腓侧供区直接缝合, 第2 足趾供区游离植皮覆盖。 结果 术后伤口及供区切口均Ⅰ期愈合。12 例再造拇指全部成活。随访2 年,再造拇指关节活动度为60 ~ 90°,平均74°;两点辨别觉为6 ~ 10 mm,平均8 mm。再造拇指功能、运动、外观均满意。 结 论 趾腓侧皮瓣嵌入塑形急诊第2 足趾移植再造拇指,具有操作简便、安全、经济的优点,外观良好,功能满意。

    Release date:2016-09-01 09:05 Export PDF Favorites Scan
  • 足母 趾腓侧皮瓣修饰性修复拇手指掌侧皮肤缺损

    【摘 要】 目的 介绍一种修复拇、手指掌侧皮肤缺损的理想手术方法。 方法 2001 年7 月- 2006 年7 月,采用足母 趾腓侧皮瓣游离移植修复拇、手指掌侧皮肤缺损28 例。男16 例,女12 例;年龄14 ~ 46 岁。挤压伤11 例,冲床伤7 例,刀具割伤3 例,火器伤3 例,咬伤2 例,慢性溃疡2 例。拇指4 例,示指7 例,中指7 例,环指6 例,小指4 例。皮肤缺损2.0 cm × 1.5 cm ~ 4.0 cm × 2.5 cm。病程3 h ~ 7 d。皮瓣切取范围2.5 cm × 1.5 cm ~ 4.5 cm × 2.5 cm。供区直接缝合或全厚植皮修复。 结果 术后28 例供受区伤口均Ⅰ期愈合,移植皮瓣及供区植皮均成活。28 例获随访6 个月~ 5 年。皮瓣外形逼真,有罗纹,质地良好,两点辨别觉4 ~ 6 mm。按中华医学会手外科学会上肢部分功能评定试用标准:优25 例,良3 例。供足行走、跑、跳功能正常。 结论 足母 趾腓侧皮瓣修复拇、手指掌侧皮肤缺损,供区损伤小,对受区周围组织破坏小,修复后效果佳,能达到修饰性修复目的。

    Release date:2016-09-01 09:10 Export PDF Favorites Scan
  • 趾腓侧皮瓣移位修复前足底创面

    前足底皮肤缺损修复极为困难。根据足部局部血供特点,设计了止母趾腓侧皮瓣移位修复前足底难治性创面5例,均获满意效果。此法优点为:①血供丰富,皮肤质地优良,带有神经,术后耐磨、耐压,可满意恢复足的行走和负重功能;②血管神经蒂长,通过“隧道”可顺利移位修复前足底各部位创面;③血管神经变异少,操作容易,有利推广。对手术方法、注意事项及足底修复特点等进行了讨论。

    Release date:2016-09-01 11:10 Export PDF Favorites Scan
  • 第一跖背动脉皮瓣串联足母趾腓侧皮瓣移植修复手部贯通伤

    目的总结采用第1跖背动脉皮瓣串联趾腓侧皮瓣游离移植修复手部贯通伤的疗效。方法2007年1月-2011年12月,采用第1跖背动脉皮瓣串联趾腓侧皮瓣游离移植修复手部贯通伤12例。男8例,女4例;年龄18~52岁,平均35岁。致伤原因:冲床伤9例,火器伤3例。受伤至入院时间3~12 h,平均6 h。患者手掌皮肤缺损范围为2.0 cm×1.5 cm~3.0 cm×3.0 cm,手背缺损范围为3.5 cm×3.0 cm~5.0 cm×4.0 cm。其中合并掌骨缺损或骨折7例,伸肌腱损伤7例,指动脉损伤3例,指总神经损伤6例。供区中厚皮片游离植皮修复。结果术后所有皮瓣及植皮均成活,创面Ⅰ期愈合。12例均获随访,随访时间6~18个月,平均10个月。皮瓣外观满意,末次随访时皮瓣两点辨别觉为0.6~1.0 cm,平均0.8 cm。根据中华医学会手外科学会上肢部分功能评定试用标准评定:获优10例,良2例。结论第1跖背动脉皮瓣串联趾腓侧皮瓣与手部皮肤外观、质地相近,吻合血管易于成活,是修复手部贯通伤的理想皮瓣。

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  • Repair of distal phalanx finger wound with modified great toe fibular flap with distal artery pedicle as reflux vein

    ObjectiveTo investigate the effectiveness of the modified great toe fibular flap using the distal artery pedicle as reflux vein for repairing distal phalanx finger wound.MethodsBetween June 2018 and January 2020, 15 patients who suffered tissue defect of the distal phalanx finger were treated, including 12 males and 3 females, the average age was 40.2 years (range, 24-56 years). All of them were caused by machine crush injury. There were 2 cases of thumb, 6 cases of index finger, 3 cases of middle finger, 3 cases of ring finger, and 1 case of little finger. The defects ranged from 1.7 cm×1.3 cm to 3.0 cm×2.0 cm. The time from injury to admission was 0.6-4 hours, with an average of 2.3 hours. The medial fibular proper digital artery was further dissociated to the distal end and anastomosed with the recipient vein as the reflux vein. The area of flaps ranged from 2.0 cm×1.5 cm to 3.2 cm×2.2 cm.ResultsAll the flaps survived without vascular crisis, and the wounds healed by first intention. Except for 1 case that the suture was too tight, the incision was partially split after the stitches were removed, and it healed spontaneously after dressing change, the other patients had good healing of the donor site incision and normal foot function. All 15 patients were followed up 3-18 months, with an average of 9.3 months. The appearance of finger pulps were satisfactory with full and threaded. The color, texture, and elasticity of the flaps were good, and the two-point discrimination was 6-8 mm at last follow-up. The flexion and extension of fingers were normal. At last follow-up, hand function was evaluated according to the upper limb function evaluation trial standard of the Chinese Medical Association Hand Surgery Society, and the results were 13 cases of excellent and 2 cases of good.ConclusionModified great toe fibular flap using the distal arterial pedicle as a reflux vein can improve the venous drainage of the flap and contribute to increase the success rate of the flap without additional injury.

    Release date:2021-02-24 05:33 Export PDF Favorites Scan
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