Objective To report the method of thenar flap transfer and evaluate its results in ring fingertip reconstruction. Methods Twenty-three patients with ring fingertip amputation who underwent reconstruction with a thenar flap between January 2009 and January 2011were evaluated.Flap sensation,appearance and the function of the interphalangeal and metacarpophalangeal joints were assessed after the operation. Results All 23 flaps survived.Postoperative follow-up ranged from 7 to 20 months.18 of 23 (78％) flaps gained protective sensation,while the mean two-point discrimin~ion in 16 flaps was 7.2 mm (range,4 to 11mm).The score of subjective appearance assessment ranged from 67 to95,with an average of 83.Functions of the metacarpalphalangeal and interphalangeal joint in the reconstructed fingers were evaluated based on total active motion (TAM) rating system,and were rated as excellent in 20 cases and good in 3 cases.There were no tendemess and contracture in the reconstructed fingers. Conclusion Thenar flap is a good and reliable option to reconstruct the ring fingertip defect,with simple surgical technique,good flap stability and highly satisfactory appearance.%目的 探讨应用鱼际皮瓣修复环指指尖缺损的方法和效果.方法 2009年1月至2011年1月,应用鱼际皮瓣修复环指指尖缺损23例,术后评价皮瓣感觉恢复及外观,评价环指指间关节及掌指关节的功能.结果 术后23例皮瓣全部存活,随访时间为7～20个月.18例(78％)皮瓣获得保护性感觉,其中16例皮瓣可测出两点分辨觉4～11mm;外观主观评分为67～95分,平均83分;按照手指总的主动活动度(TAM)评级标准评定:优20例,良3例.所有患者重建后的环指指尖无压痛,供区无触痛.结论 鱼际皮瓣是修复环指指尖缺损的较好方法.手术操作简单,皮瓣稳定性强,外观满意度高.
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