标题：以指蹼交通支为蒂的掌背动脉皮瓣修复指背中远节皮肤缺损

      作者：张军 1，赵凯敏 1，边云龙 1，王勇峰 1，白雨微 2    西安医学院附属宝鸡医院骨外科二病区 1、科研科 2，陕西 宝鸡 721006

      卷次： 2021年32卷21期

      【摘要】 目的 探讨应用以指蹼交通支为蒂的掌背动脉皮瓣修复指背中远节皮肤缺损的方法和临床效果。方法 选取2019年8月至2021年1月在西安医学院附属宝鸡医院骨外科二病区就诊的9例因外伤导致的指背中远节皮肤缺损患者采用逆行掌背动脉皮瓣修复，延长并游离掌背动脉的指蹼交通支至指固有动脉，以指蹼交通支和指掌侧总动脉或指固有动脉交汇处为旋转点蒂旋转，修复手指背中远节皮肤缺损。结果 术后9例皮瓣全部成活，伤口均Ⅰ期愈合，随访时间为3~6个月，皮瓣外形及手指功能恢复满意。术后患指关节伸屈功能根据总主动活动度(TAM)系统评定法评定，优8例，良1例。结论 采用指蹼交通支为蒂的掌背动脉皮瓣修复指背中远节皮肤缺损，延长了皮瓣蒂部，降低皮瓣张力，手术操作简单，是一种修复指背缺损的较好方法。
      【关键词】 掌背动脉皮瓣；指蹼交通支；逆行转移；皮瓣修复；指背缺损
      【中图分类号】 R62 【文献标识码】 A 【文章编号】 1003—6350（2021）21—2794—04

Repairing of skin defect of middle and distal segment of finger back by dorsal metacarpal artery flap pedicledwith communicating branch of finger web.
ZHANG Jun 1, ZHAO Kai-min 1, BIAN Yun-long 1, WANG Yong-feng 1, BAIYu-wei 2. The Second Ward of Orthopaedic Surgery 1, Department of Scientific Research 2, Baoji Hospital Affiliated to Xi'anMedical University, Baoji 721006, Shaanxi, CHINA
【Abstract】 Objective To explore the method and clinical effect of repairing skin defect of middle and distal seg-ment of finger back by dorsal metacarpal artery flap pedicled with communicating branch of finger web. Methods A to-tal of 9 patients with skin defects of the middle and distal dorsal segment of the finger caused by trauma, treated with re-verse dorsal metacarpal artery flap in the Second Ward of Orthopedic Surgery, Baoji Hospital Affiliated to Xi'an MedicalCollege from August 2019 to January 2021, were selected as the research subjects. The communicating branch of the dor-sal metacarpal artery was extended and free to the proper digital artery. The intersection of the communicating branch ofthe dorsal metacarpal artery and the common palmar digital artery or the proper digital artery was used as the rotationpoint to repair the skin defects of the middle and distal dorsal segment of the finger. Results After the operation, all theskin flaps survived, and the wounds healed by first intention. The average follow-up time of the patients was 3 to 6months, and the shape of the flap and the function of the fingers recovered satisfactorily. The postoperative extension andflexion function of the affected knuckles was evaluated according to the total active motion (TAM) system evaluationmethod: 8 cases were excellent and 1 case was good. Conclusion Dorsal metacarpal artery flap pedicled with the com-municating branch of the finger web is a good method to repair the skin defect of the middle and distal segment of thefinger back.
      【Key words】 Dorsal metacarpal artery flap; Digital web communicating branch; Retrograde metastasis; Flap re-pair; Finger dorsal defect·短篇论著·doi:10.3969/j.issn.1003-6350.2021.21.020基金项目：陕西省宝鸡市卫生健康委员会(编号：2018-69)