带蒂腹股沟皮瓣重建第一蹼区及手背挛缩。

Eplasty Pub Date : 2022-08-09 eCollection Date: 2022-01-01
Lauren Jacobson, Rachel Skladman, Charles T Tuggle, Mitchell A Pet
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引用次数: 0

摘要

背景。第一网窝和手背挛缩的结合是一个具有挑战性的重建问题。完全的软组织释放导致一个大的环绕性缺损,横跨手掌的桡侧、第一蹼空间和整个手背的横向尺寸。在这些情况下,局部组织经常受损,游离皮瓣重建通常是指。然而,在患者不愿或不能进行显微手术重建的情况下,局部组织转移提供了一种替代重建策略。本病例报告描述了3例严重的第一蹼和手背联合挛缩的患者。每位患者相对禁忌症为局部或游离组织移植,并采用2期选择性挛缩释放术治疗,伴有渐进式背侧和掌侧缺损创建,并使用带蒂腹股沟皮瓣覆盖。该手术需要在软组织释放过程中进行周密的计划,以协调分阶段的、背侧的、掌侧的、缺损的产生以及腹股沟皮瓣远端和近端的逐步解放。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Pedicled Groin Flap for Reconstruction of Combined First Webspace and Dorsal Hand Contracture.

Background. The combination of first webspace and dorsal hand contracture is a challenging reconstructive problem. Complete soft tissue release results in a large wraparound defect that spans the radial side of the palm, first webspace, and the transverse dimension of the entire dorsal hand. In these situations local tissue is often compromised, and free flap reconstruction is commonly indicated. However, in cases where patients are unwilling or unable to undergo microsurgical reconstruction, regional tissue transfer provides an alternative reconstructive strategy. This case report describes a series of 3 patients with severe combined contractures of the first webspace and dorsal hand. Each patient was relatively contraindicated for local or free tissue transfer and was treated with 2-stage selective contracture release with progressive dorsal then volar defect creation and coverage using a pedicled groin flap. This operation requires thoughtful planning during soft tissue release to coordinate staged, dorsal then volar, defect creation with the progressive liberation of the groin flap at its distal and then proximal ends.

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