應用手指側背皮瓣以重建屈曲攣縮

Dorsolateral Flap to Relieve Flexion Contracture of Fingers

陳恆常(Heng-Chang Chen)

《中華民國重建整形外科醫學會雜誌》 3卷4期 (1994/12) Pp. 213-218

https://doi.org/10.7096/JPRSA.199412.0213

摘要

因外傷或燙傷引起之手指屈曲攣縮常為治療上的難題。應用同一手指的側背皮瓣，以覆蓋腹面疤痕於鬆解攣縮後之皮膚缺損，可以有效恢復其功能及外觀。其優點為：具神經血管莖，皮瓣可靠且具同一指神經支配之感覺，可一次手術完成，適合多指及年紀較大或較小病患等。其適應症為近位或中位指節部位之疤痕攣縮，較遠位者則可改採逆流之遠位皮瓣重建。當疤痕及攣縮範圍較廣大時，可再配合植皮或局部皮瓣以完成覆蓋。
謹報告三年來應用於九位病患十六隻手指之經驗，及良好結果。

關鍵字

側背皮瓣 ； 屈曲攣縮

並列摘要

Volar contracture of the finger after burn or trauma is a therapeutic problem. The skin defect after release of the scar contracture can be covered by dorsolateral flap from the same finger with good functional and aesthetic result The advantages are: a reliable pedicle and sensory flap, one-staged procedure, and applicable for multiple fingers and also for younger children. This flap is indicated for lesion at the proximal interphalangeal joint region of the finger. For lesion at the distal region, this flap may be modified as a distal-based flap based on reverse flow. With concomittant contracture involving metacarpo-phalangeal joint or with lager scar areas, additional local flaps like lateral digital flap (seagull flap) and/or skin grafting may be required to achieve full extension.
We report experiences on sixteen fingers over nine patients with good result.

並列關鍵字

dorsolateral flap ； flexion contracture