Sensate First Dorsal Metacarpal Flap for Thumb and Finger Reconstruction

十一位患者因創傷造成單一拇指或手指壓碎傷，使用第一背掌指感覺皮瓣來修復其中包括五位島狀神經血管皮瓣，四位逆行皮瓣，二位自由皮瓣。皮瓣大小從2.5×1.5公分至7.0×3.0公分。逆行皮瓣和自由皮瓣的橈神經分支均和鄰近指神經分支吻合，所有皮瓣均存活。其中二個逆行皮瓣術後發生水泡，但一週後均完全存活。在術後六個月至一年的追蹤，靜態兩點感覺辨別可達8-15mm。手指功能的恢復也令人滿意。第一背掌指皮瓣的血流固定且含豐富的血管網，故逆行皮瓣可依指動脈的背支與第一背掌指動脈的終端支互相吻合，而有三個轉折點。第一背掌指感覺皮瓣的優點有容易分離，無需犧牲主要的動脈，並可提供有感覺且類似的組織以供拇指和手指的重建。

關鍵字

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並列摘要

Eleven crush injuries of thumb and finger have been repaired using sensate first dorsal metacarpal flap, including 5 neurovascular island, 4 reverse, and 2 free flaps. The size of the flaps ranged from 2.5×1.5 cm to 7.0×3.0 cm. The dorsal branch of the superficial radial nerve of the reverse or free flap was anastomosed to the branch of the palmar digital nerve. All flaps survived completely. Two of the reverse flaps developed congestion and blistering post-operatively and survived completely one week later. After 6 to 12 months' follow-up, the static two-point discrimination ranged from 8 to 15 mm (mean 11.1 mm). The functional results were satisfactory. The first dorsal metacarpal flap is rich of vascular networks and its pedicle is constant. The three pivot points of the reverse flap are based on the connection between the dorsal branch of the proper digital artery and the terminal branches of the first dorsal metacarpal artery. The design of sensate first dorsal metacarpal flaps has also the advantages of easy dissection, no requirement of sacrifice of major digital artery, sensate and similar tissues for thumb and finger reconstruction.

並列關鍵字

first dorsal metacarpal flap ； neurovascular island ； reverse ； free ； sensate flap ； thumb and finger reconstruction

國際替代計量

Sensate First Dorsal Metacarpal Flap for Thumb and Finger Reconstruction

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