两种带蒂皮瓣转移修复手指掌侧缺损的比较
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1.唐山市第二医院;2.华北理工大学中医学院

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河北省医学科学研究计划项目(编号:20201453)河北省医学适用技术跟踪项目(编号:GZ2021030)


Comparison of two kinds of pedicled flap for repairing volar defect of fingers
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Affiliation:

1.the second hospital of Tangshan;2.College of traditional Chinese medicine, North China University of Science and Technology

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Project Plan of Medical Science Research of Hebei Province (20201453); Tracking Project of Medical Applicable Technology in Hebei Province (GZ2021030)

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    摘要:

    [目的] 探讨指动脉背侧支皮瓣与掌背动脉返支皮瓣急诊修复手指中末节掌侧软组织缺损的临床疗效。 [方法] 2015年5月—2020年8月,共收治第2 ~ 5指中末节掌侧软组织缺损急诊入院患者46 例(46指),进行前瞻性研究。抽签法随机采用指动脉背侧支皮瓣(指背侧支组)与掌背动脉返支皮瓣(掌背返支组)进行修复。比较两组患者围手术期情况及随访期指标。 [结果] 两组患者均顺利完成手术,均未发生严重意外情况。掌背返支组在供区闭合方面显著优于指背侧支组(P < 0. 05),而两组手术时间、术后1周皮瓣成活面积、供区切口愈合、拆线时间及住院时间的差异均无统计学意义(P > 0. 05)。所有患者均获随访,两组随访时间比较差异无统计学意义(P = 0.483)。指背侧支组患者皮瓣静态两点辨别觉及外观满意度优于掌背返支组(P < 0. 05),而两组患者伤指关节总主动活动度的差异无统计学意义(P > 0. 05)。[结论] 相对于掌背动脉返支皮瓣,指动脉背侧支皮瓣感觉更好、外形更美观,更适合急诊修复手指中末节掌侧软组织缺损。

    Abstract:

    [Objective] To explore the clinical effect of the flaps pedicled with dorsal branch of digital artery and recurrent branch of dorsal metacarpal artery in emergency repair of volar soft tissue defect of middle and distal phalanxes of finger. [Methods] The prospective study was used. From May 2015 to August 2020,a total of 46 cases (46 fingers) with volar soft tissue defect of middle and distal segments in 2 ~ 5 fingers were admitted to our hospital. They were divided into two groups by drawing lots, which were repaired by the dorsal branch of digital artery flap (dorsal digital branch group) and recurrent branch of dorsal metacarpal artery flap (dorsal metacarpal recurrent branch group). The data of perioperative period and follow-up were compared between both groups. [Results] All the patients in the two groups were performed surgical procedures successfully without serious accidents. The dorsal metacarpal recurrent branch group was significantly superior to the dorsal digital branch group in donor-site closure (P < 0.05), whereas there was no significant difference between both groups in operation time, flap survival area at 1 week postoperatively, donor-site incision healing, time to remove stitch and hospital stay (P > 0. 05). All patients were followed up, and there was no significant difference between the two groups (P > 0. 05). The static two-point discrimination and appearance satisfaction in the dorsal digital branch group were better than those in the dorsal metacarpal branch group (P < 0.05), and there was no significant difference in total active motion of finger joints between the two groups (P > 0. 05). [Conclusions] Compared with the recurrent branch of dorsal metacarpal artery flap, the dorsal digital artery flap has better sense and appearance, and is more suitable for emergency repair of volar soft tissue defect of the middle and distal phalanxes of the finger.

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  • 收稿日期:2022-06-16
  • 最后修改日期:2022-08-24
  • 录用日期:2022-12-20
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