Zyluk Andrzej, Walaszek Ireneusz, Puchalski Piotr
Klinika Chirurgii Ogólnej i Chirurgii Reki, Pomorska Akademia Medyczna w Szczecinie.
Chir Narzadow Ruchu Ortop Pol. 2005;70(1):17-20.
The use of the first dorsal metacarpal artery flap in the reconstruction of soft tissue defects in 6 patients suffered from severe injuries of the thumb is presented. Detailed description of the operative technique is given and results of the treatment of 3 patients who were examined at 1-2 years after operation are evaluated. All flaps healed uneventfully and defects were covered in all patients without terminalization of the thumb. Functional results were satisfactory in 2 patients, but other one considered his hand incompletely dexter, by means of decreased both total grip and pinch strengths. In the other patient a limited range of motion occurred in MCP joint of the index finger from which the flap was harvested. Sensation of light touch was satisfactory in two patients and decreased in one, and 2PD discrimination was of 10 mm in all 3 patients. Presented technique seems to be useful and relatively safe in the reconstruction of severely injured thumbs, and for rearrangement of sensation within the thumb.
本文介绍了应用第一掌背动脉皮瓣修复6例拇指严重损伤软组织缺损的情况。详细描述了手术技术，并对3例术后1 - 2年接受检查的患者的治疗结果进行了评估。所有皮瓣均顺利愈合，所有患者的缺损均得到覆盖，拇指未出现坏死。2例患者功能结果满意，但另1例患者因总握力和捏力下降，认为手部灵巧性未完全恢复。在另1例患者中，供皮瓣的示指掌指关节活动范围受限。2例患者轻触觉感觉满意，1例感觉减退，所有3例患者两点辨别觉均为10 mm。所介绍的技术在修复严重损伤的拇指及拇指感觉重建方面似乎是有用且相对安全的。
