摘要目的 报道带部分尺侧屈腕肌腱的尺动脉腕掌侧穿支皮瓣游离移植修复指背皮肤软组织合并伸指肌腱缺损的临床效果.方法 自2008年6月至2012年6月,对15例指背皮肤软组织合并伸指肌腱缺损采用带部分尺侧屈腕肌腱的游离尺动脉腕掌穿支皮瓣移植修复,切取面积为2.0 cm ×2.5 cm～3.0 cm ×6.0 cm:带1/2厚度屈腕肌腱长2.0～5.5 cm,并借腱膜保留在皮瓣内不分离,保持移植肌腱的血供.前臂内侧皮神经的终末支与指背神经修复6例,未修复9例;直接与指固有动脉主干吻合5例,与指动脉分支吻合4例,与指背动脉吻合6例,供区均直接缝合.结果 术后皮瓣均成活,随访6个月～2年,皮瓣不臃肿,修复神经者感觉恢复S3～S3+.根据中华医学会手外科学会上肢部分功能评定试用标准评定,结果优11例,良3例,中1例.腕部供皮区愈合良好,腕关节活动及屈腕肌腱肌力无影响.结论 采用带部分尺侧腕肌腱的尺动脉腕掌侧穿支皮瓣修复指背皮肤合并伸指肌腱缺损,能在一个手术区域完成复合修复,血管分离快捷,不破坏手部外观,对供区损伤小,是修复指背复合软组织缺损行之有效的方法之一.

abstractsObjective To explore the clinical effect of the free flap with suracarpal palmar perforator of ulnar artery and partial flexor carpi ulnaris tendon repairing dorsal skin defect of finger.Methods From June 2008 to June 2012,fifteen patients with dorsal skin defect of finger were repaired with the free flap with suracarpal palmar perforator branch of ulnar artery and partial flexor carpi ulnaris tendon.The flaps were 2.0 cm × 2.5 cm-3.0 cm × 6.0 cm.The size of the tendens with half thickness was 2.0-5.5 cm.There were 6 cases were repaired the medial cutaneous nerve of forearm and the dorsal digital nerve,the other 9 cases were not repaired the nerve.There were 5 cases to coincide with the common palmar digital artery directly,4 cases with the branch of the digital artery and 6 cases with the dorsal digital artery.The donor were all directly sutured.Results The flaps were all survival.The flaps were not bulky,the sensation was S3-S3 +.The scar of the abdominal donor site was small.Acorrding tentative standard of the functional evaluation of the replantation of broken limb evaluated by Chinese Medical Association,the results were excellent in 11 cases,good in 3 cases,fair in 1 case.The scars of the donor sites was small.The motion and power of wrists were normal.Conclusion Using the free flap with suracarpal palmar perforator branch of ulnar artery and partial flexor carpi ulnaris tendon to repair dorsal skin defect of finger may achieve composite repairment in one operational site,detachment of the vessel is quick,the hand appearance is not broken and the donor is mild destroyed.This flap is a better treatment to repair the hand skin and soft tissues defects.