Xu Y, Li Z, Li Q
Orthopedic Center of PLA, Kunming General Hospital of Chengdu Military Area, P.R. China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 1997 Sep;11(5):293-5.
It is difficult to repair the pulp defect of finger with good function. Here reported two cases of pulp defect of the thumb which were repaired with free palmris brevis musculo-cutaneous flap. The flap was designed as the following: taken the line crossing the pisiform and metacarpo-phalangeal joint of the little finger as the longitudinal axis of the flap. The proximal end of the flap was at the level of pisiform and the distal end was the distal transverse palmar crease. The radial border was the radial side of the palmris brevis and ulnar border was the ulnar edge of the palm. The flap should not be larger than 6.5 cm x 2.5 cm. The flap was dissected with proper ulnar vessels and the accompanying arterial branch and superficial branch of the ulnar nerve. The flap was transferred to repair the pulp defect of the thumb. The vessels were anastomosed with the radial artery and cephalic vein at the snuffbox. The nerves were sutured to the digital nerve. Three months after operation, the defect was healed and the sensation of pulp was recovered. The donor area was painless and without sensation disturbance. The motion of the little finger was normal. The function of the thumb was restored. It was concluded that the palmaris brevis musculocutaneous flap is one of the best donor region to repair pulp defect of thumb.
修复手指的 pulp 缺损并使其功能良好较为困难。本文报道了两例采用游离小鱼际肌皮瓣修复拇指 pulp 缺损的病例。皮瓣设计如下：以过豌豆骨与小指掌指关节的连线作为皮瓣的纵轴。皮瓣近端位于豌豆骨水平，远端为远侧掌横纹。桡侧缘为小鱼际桡侧，尺侧缘为手掌尺侧缘。皮瓣大小不应超过6.5 cm×2.5 cm。沿尺侧适当的血管、尺动脉伴行分支及尺神经浅支解剖皮瓣。将皮瓣转移修复拇指 pulp 缺损。血管在鼻烟窝处与桡动脉和头静脉吻合。神经与指神经缝合。术后3个月，缺损愈合，pulp 感觉恢复。供区无痛且无感觉障碍。小指活动正常。拇指功能恢复。结论：小鱼际肌皮瓣是修复拇指 pulp 缺损的最佳供区之一。 （注：文中“pulp”可能在医学中有特定含义，结合语境推测这里是指手指的特定部位，但不太明确具体准确的中文表述，所以保留英文未翻译）
