Free anterolateral thigh flaps with fascia lata for repair of dorsal tendon and soft tissue defect of ophisthenar

中华显微外科杂志 Pub Date : 2019-04-25 DOI:10.3760/CMA.J.ISSN.1001-2036.2019.02.008

S. Xiong, J. Ju, G. Jin, Lin-feng Tang, Guangliang Zhang, Xiang-jun Li

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Abstract

Objective To explore the surgical technique and clinical effects of free anterolateral thigh flaps with fascia lata for repair of dorsal tendon and soft tissue defect of ophisthenar. Methods From February, 2014 to July, 2016, dorsal tendon and soft tissue defect of ophisthenar in 13 cases was repaired by free anterolateral thigh flaps with fascia lata. The area of soft tissue defect was 5.0 cm×6.0 cm-9.0 cm×12.0 cm. Extensor tendon defect and bone exposure occurred in all cases. The area of flap was 6.0 cm×7.0 cm-10.0 cm×13.0 cm, while the area of anterolateral thigh flap was 3.0 cm×4.0 cm-6.0 cm×8.0 cm. The regular post-operatively followed-up was performed. Results All flaps survived. The donor sites healed well without skin graft. The followed-up time was 6-36 months with the average of 13 months. The appearance of the flap was good. The color and texture of flaps was similar to the dorsal skin of ophisthenar. Three female patients who were not satisfied with the flap appearance received the revision and the results were satisfactory. The activity of finger flexion and extension was satisfactory. All patients walked well without difficulty. According to the Upper Extremity Functional Evaluation Standard set up by Hand Surgery Branch of Chinese Medical Association, the function recovery result was excellent in 8 cases, good in 4 cases, and poor in 1 case. Conclusion It is a good method to use the free anterolateral thigh flaps with fascia lata to repair of dorsal tendon and soft tissue defect of ophisthenar. Key words: Anterolateral thigh flap; Fascia lata; Opisthenar; Soft tissue defect; Tendon defect; Repair

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阔筋膜股前外侧游离皮瓣修复胫后肌腱及软组织缺损

目的探讨阔筋膜股前外侧游离皮瓣修复胫后肌腱及软组织缺损的手术方法和临床效果。方法自2014年2月至2016年7月，采用阔筋膜股前外侧游离皮瓣修复13例滑脱症患者的背肌腱及软组织缺损。软组织缺损面积5.0cm×6.0cm～9.0cm×12.0cm，均发生伸肌腱缺损和骨外露。皮瓣面积6.0cm×7.0cm～10.0cm×13.0cm，股前外侧皮瓣面积3.0cm×4.0cm～6.0cm×8.0cm，术后定期随访。结果皮瓣全部成活。供区愈合良好，无需植皮。随访时间6～36个月，平均13个月。皮瓣外观良好。皮瓣的颜色和质地与滑脱背侧皮肤相似。三名对皮瓣外观不满意的女性患者接受了翻修，结果令人满意。手指屈伸活动良好。所有病人走路都很顺利，没有任何困难。根据中华医学会手外科分会制定的上肢功能评定标准，功能恢复结果优8例，良4例，差1例。结论应用阔筋膜股前外侧游离皮瓣修复胫后肌腱及软组织缺损是一种较好的方法。关键词：大腿前外侧皮瓣；阔筋膜；Opisthnar；软组织缺损；肌腱缺损；修理

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来源期刊

中华显微外科杂志

CiteScore

0.50

自引率

0.00%

发文量

6448

期刊介绍： Chinese Journal of Microsurgery was established in 1978, the predecessor of which is Microsurgery. Chinese Journal of Microsurgery is now indexed by WPRIM, CNKI, Wanfang Data, CSCD, etc. The impact factor of the journal is 1.731 in 2017, ranking the third among all journal of comprehensive surgery. The journal covers clinical and basic studies in field of microsurgery. Articles with clinical interest and implications will be given preference.