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目的 探讨携带浅静脉的骨间后动脉岛状皮瓣在复杂性断指再植中的应用及疗效.方法 自2009年1月至2013年1月,对8例复杂性断指采用携带浅静脉的骨间后动脉岛状皮瓣移位重建断指静脉回流,并一期修复创面.所有患指均有手背严重软组织缺损及节段性静脉缺损,指体血运障碍.离断手指的指固有动脉断端直接吻合,骨间后动脉岛状皮瓣上的皮下浅静脉与指背浅静脉吻合.皮瓣切取面移为8.0 cm×3.0 cm～ 13.0 cm×8.0 cm.结果 术后所有断指、皮瓣均顺利存活.随访6～24个月,平均8.3个月,皮瓣色泽、质地好,恢复保护性感觉.结论 携带浅静脉的骨间后动脉岛状皮瓣可同时修复手背创面并重建断指静脉回流,适用于伴手背皮肤软组织缺损的复杂性断指再植病例.

Objective To explore the surgical procedure and evaluate the treatment outcomes of transferring posterior interosseous artery island flap with a superficial vein in the flap for repairing soft tissue defects of the dorsum hand in complex finger replantation.Methods From January 2009 to January 2013,8 cases of complex finger replantation accompanied with soft tissue defects were treated with this procedure.The superficial vein in the flap served as flow-through drainage vein for the replanted finger while the flap covered the soft tissue defect simultaneously.The proper arteries of the severed finger were anastomosed directly.The dorsal veins of the fingers were anastomosed with the superficial veins in the flaps.The areas of the harvested flaps ranged from 8.0 cm×3.0 cm to 13.0 cm×8,0 cm.Results All fingers and flaps survived uneventfully.Postoperative follow-up ranged from 6 to 24 months,with an average of 8.3 months.The flaps had good color and texture,Protective sensation was restored.Conclusion Transfer of the posterior interosseous artery flap with superficial veins can restore venous drainage of the replanted fingers and repair the hand defects in one stage.It is suitable in covering soft tissue defects of the hands in complex finger replantation cases.