Vạt da cân thần kinh bì cẳng tay ngoài có bộc lộ cuống mạch đầu xa che phủ khuyết hổng mô mềm bàn tay=The lateral antebrachial neurofasciocutaneous flap with detecting the location of the distal perforators of the radial artery for hand soft tissue defects reconstruction

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Tác giả: Trọng Tường Mai, Tấn Bảo Ân Nguyễn, Phan Vinh Hiển Trần

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Y học Cộng đồng, 2024

Mô tả vật lý: tr.178-185

Bộ sưu tập: Metadata

ID: 253066

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Các nghiên cứu về vạt da cân thần kinh bì cẳng tay ngoài cuống đầu xa trong điều trị che phủ khuyết hổng mô mềm bàn tay, chưa thống nhất về vị trí điểm xoay của vạt da. Vì vậy, nghiên cứu thực hiện nhằm xác định vị trí nhánh xuyên đầu xa động mạch quay phù hợp là điểm xoay của vạt da cân thần kinh bì cẳng tay ngoài. Đối tượng và phương pháp nghiên cứu: Báo cáo loạt ca, tiến cứu. Bệnh nhân có khuyết hổng mô mềm bàn tay và lộ mô quý (gân, xương), theo dõi ít nhất 6 tháng.Kết quả: 33 vạt da sống (94,3%), 02 vạt da hoại tử đầu xa. Vị trí điểm xoay của vạt da cách mỏm trâm quay: 4 cm (26 ca), 6 cm (9 ca). Vạt da che phủ nhiều vị trí tổn thương của bàn tay, không có biến chứng và di chứng.Bàn luận: Bộc lộ cuống mạch đầu xa của vạt da cân thần kinh bì cẳng tay ngoài trong điều trị khuyết hổng mô mềm bàn tay là bước quan trọng của bóc tách vạt da.Kết luận: Vạt da cân thần kinh bì cẳng tay ngoài có bộc lộ cuống mạch đầu xa hữu ích trong tái tạo khuyết hổng mô mềm bàn tay, không có biến chứng và di chứng.There is still no consensus among researchers regarding the pivot point of the distally based lateral antebrachial neurofasciocutaneous flap, using for coverage of hand soft tissue defects. Therefore, this study aimed to determine the approriate location of the distal perforators of the radial artery as the pivot point of the lateral antebrachial neurofasciocutaneous flap. Materials and Methods: The prospective case series study applies the lateral antebrachial neurofasciocutaneous flap with detecting the location of the distal perforators of the radial artery for reconstruction of hand soft tissue defects with exposed tendon or bone. All cases were followed up at least 6 months. Results: Thirty-three flaps (33/35) were survived (94,3%). Two flaps (02/35) suffered from distal superficial necrosis. The pivot point was located above the radial styloid process: 4 cm (26 flaps), 6 cm (9 flaps). The flap can cover many sides of hand, without complication and sequel. Dicussion: Detecting the location of the distal perforators of the radial artery is the important step in harvesting the lateral antebrachial neurofasciocutaneous flap for reconstruction of hand soft tissue defects.Conclusions: The distally based lateral antebrachial neurofasciocutaneous flap with detecting the location of the distal perforators of the radial artery is useful for coverage of hand soft tissue defects, without complication and sequel.

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