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创伤性手部损伤中骨间后动脉皮瓣的应用

Posterior interosseous artery flap in traumatic hand injuries.

作者信息

Ege Ahmet, Tuncay Ibrahim, Erçetin Omer

机构信息

Department of Orthopaedics & Traumatology, Karaelmas University Medical School, 67600 Kozlu/Zonguldak, Turkey.

出版信息

Arch Orthop Trauma Surg. 2003 Sep;123(7):323-6. doi: 10.1007/s00402-003-0540-x. Epub 2003 Jun 28.

Abstract

INTRODUCTION

Nineteen cases of posterior interosseous artery (PIOA) flap were reviewed. The patients' mean age was 24 (range 14-53) years.

MATERIALS AND METHODS

Nine patients were operated on as emergencies, and 10 patients were treated electively. Mean time of delay after trauma was 7.8 h (range 2-20 h) in emergency cases. Nine of them were non-replantable amputations. Skin defects were between 1.9 x 2.4 cm and 5.0 x 12.0 cm. Mean hospitalization time was 2.2 (range 1-5) days.

RESULTS

Mean flap sensation was evaluated as 2.83-6.65 with the Semmes-Weinstein evaluation scale (only 2 patients scored less than 3.61). Five patients presented with discoloration and coolness. Average subjective evaluation was 8.2/10. Mean web opening after first web reconstruction was 40 degrees. One posterior interosseous neuropraxia ( recovered in 4 months), one distal flap necrosis, and one flap lost (due to infection) occurred as early complications. Mean follow-up was 12.8 months (range 15 days to 30 months).

CONCLUSIONS

PIOA flap applications have reduced the need for lateral arm and radial forearm flaps and also shortened hospitalization time in clinical practice.

摘要

引言

回顾了19例骨间后动脉(PIOA)皮瓣病例。患者的平均年龄为24岁(范围14 - 53岁)。

材料与方法

9例患者为急诊手术,10例为择期治疗。急诊病例创伤后平均延迟时间为7.8小时(范围2 - 20小时)。其中9例为不可再植性截肢。皮肤缺损面积在1.9×2.4厘米至5.0×12.0厘米之间。平均住院时间为2.2天(范围1 - 5天)。

结果

采用Semmes - Weinstein评估量表评估皮瓣平均感觉为2.83 - 6.65(只有2例患者得分低于3.61)。5例患者出现皮瓣变色和发凉。主观平均评分为8.2/10。首次重建虎口后平均虎口开度为40度。早期并发症包括1例骨间后神经失用(4个月后恢复)、1例远端皮瓣坏死和1例皮瓣丢失(因感染)。平均随访时间为12.8个月(范围15天至30个月)。

结论

在临床实践中,骨间后动脉皮瓣的应用减少了对臂外侧皮瓣和桡侧前臂皮瓣的需求,也缩短了住院时间。

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