本文選題：指損傷　切入點(diǎn)：趾　出處：《蘇州大學(xué)》2015年碩士論文

【摘要】：目的:探索第二趾趾端復(fù)合組織串聯(lián)趾側(cè)方皮瓣修復(fù)指端缺損的血管解剖學(xué)基礎(chǔ)及臨床應(yīng)用療效。方法:研究包括基礎(chǔ)研究和臨床應(yīng)用兩部分�；A(chǔ)研究包括尸體解剖:本研究采用6側(cè)新鮮成人下肢肢體,其中4側(cè)采用紅色乳膠進(jìn)行動(dòng)脈灌注,2側(cè)冰凍尸體解凍后直接解剖。在顯微鏡下解剖趾足底固有動(dòng)脈,遠(yuǎn)端至趾端。用游標(biāo)卡尺測(cè)量趾足底固有動(dòng)脈穿支發(fā)出的部位及口徑。臨床對(duì)16例16指拇、手指指端復(fù)合組織缺損的患者,設(shè)計(jì)以趾足底固有動(dòng)脈—甲皺襞血管筋膜蒂為蒂的第二趾趾端復(fù)合組織串聯(lián)趾側(cè)方皮瓣進(jìn)行瓦合修復(fù)。結(jié)果:所有的標(biāo)本中均可發(fā)現(xiàn)趾足底固有動(dòng)脈及其終末甲床支及骨纖維支。趾足底固有動(dòng)脈于甲皺襞以近7.6±0.7mm處發(fā)出終末甲床支,于甲皺襞以近3.3±0.1mm處發(fā)出骨纖維支。它們與甲周表皮的側(cè)方距離為3.8±1.0mm。終末甲床支及骨纖維支的直徑分別為0.8±0.2mm和0.7±0.1mm,趾足底固有動(dòng)脈的直徑為1.4±0.2mm。臨床應(yīng)用16例,16例皮瓣全部成活,隨訪時(shí)間為4~17個(gè)月,平均12個(gè)月。手指功能恢復(fù)優(yōu)良,皮瓣感覺(jué)恢復(fù)分級(jí)S2-S3+,外觀逼真,指甲生長(zhǎng)外形良好,供區(qū)趾甲生長(zhǎng)良好,趾端無(wú)疼痛,植皮無(wú)破潰發(fā)生。結(jié)論:趾足底固有動(dòng)脈的終末甲床支及骨纖維支解剖恒定,設(shè)計(jì)以趾足底固有動(dòng)脈—甲皺襞血管筋膜蒂為蒂的第二趾趾端復(fù)合組織串聯(lián)趾側(cè)方皮瓣進(jìn)行瓦合修復(fù)指端缺損,受區(qū)外形好,供區(qū)損傷小。
[Abstract]:Objective: to explore the vascular anatomical basis and clinical application of the second toe end combined with tissue series digital lateral flap for the repair of phalanx defect. Methods: the study includes two parts: basic research and clinical application. The basic research includes cadaver. Somatic anatomy: six fresh adult lower extremities were used in this study. Among them, 4 sides were directly dissected from frozen cadavers by arterial perfusion with red latex after thawing. The proper artery of toe plantar was dissected under microscope. Using Vernier caliper to measure the position and caliber of perforating branches of the propria plantar artery of the toe. 16 cases of 16 patients with complex tissue defects of thumb and finger tips were treated with Vernier caliper. The second toe end combined tissue combined with toe lateral flap pedicled with the pedicle of Arteria propria digitorum propria digitorum nailfold vascular fascia was designed for repair. Results: the proper artery of toe sole and its terminal nail could be found in all specimens. The branches of bed and fibrous bone. The artery propria propria of toe plantar sends out the final branch of nail bed at nearly 7.6 鹵0.7mm in nailfold. Bone fibrous branches were sent out in the nailfold at nearly 3.3 鹵0.1mm. The lateral distance between them and the epidermis around the nail was 3.8 鹵1.0 mm. the diameter of the bed branch and the fibrous branch of the end nail were 0.8 鹵0.2mm and 0.7 鹵0.1 mm, respectively, and the diameter of the propria plantar artery of the toe was 1.4 鹵0.2 mm. The follow-up time ranged from 4 to 17 months (mean 12 months). The finger function recovered well, the skin flap sensory recovery grade was S2-S3, the appearance was lifelike, the fingernail grew well, the donor nail grew well, and the toe end had no pain. Conclusion: the final nail bed branch and bone fibrous branch of the toe plantar propria artery are constant. The second toe end combined tissue series toe lateral flap pedicled with the pedicle of the artery propria propria digitorum nailfold vascular fascia was designed to repair the defect of finger tip. The shape of the recipient area was good and the injury of donor area was small.
【學(xué)位授予單位】：蘇州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類(lèi)號(hào)】：R658.2

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本文編號(hào)：1679925