手指外傷における前腕内側皮神経を用いた血管柄付き神経皮膚移植術―新しい試み

概要

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We report the results of a novel method using the forearm venous flap with the medial antebrachial cutaneous nerve for reconstruction of a composite soft tissue defect of a digit, which included a digital nerve, artery, and skin. Four patients underwent the reconstruction (1 index finger, 2 middle fingers, and 1 ring finger) were evaluated. The length of the medial antebrachial cutaneous nerve grafts ranged from 2 to 5.5 cm, with a mean length of 3.6 cm. All of the venous flaps were successful. In the 3 patients for whom the follow-up period was over 6 months, the sensibility scores of the tips of the treated fingers were 11, 6, and 5, respectively, on s-2 PD and all 3 could sense filament #6 on the Semmes-Weinstein test. The results of this study show that, in patients with composite soft tissue defect including a digital nerve, artery and skin, forearm venous flap with the medial antebrachial cutaneous nerve grafting should be considered as a clinical alternative for nerve reconstruction of the digits.
中国・四国整形外科学会の論文