目的：探讨游离足背同蒂多叶皮瓣治疗多指指背皮肤缺损的手术方法及临床疗效。方法2009年3月—2013年5月，采用单足背二叶皮瓣移植修复多指指背皮肤缺损4例8指；单足背三叶皮瓣移植修复3例9指；双足背各二叶皮瓣移植修复2例8指。皮瓣面积：2.0 cm×3.0 cm~3.0 cm×8.0 cm。结果本组9例25指皮瓣全部成活。术后7例21指获得6~24个月随访，皮瓣血运好，质地色泽与周边相似，稍臃肿，手指外形及功能满意，患指伸指功能得到重建，掌指关节（metacarprophalangeal joint, MP ）屈曲90°，其余指间关节活动接近正常，皮瓣感觉恢复，两点辨别觉8~12 mm。供区功能基本无影响，步态及弹跳正常。结论游离足背同蒂多叶皮瓣是治疗多指指背皮肤缺损恢复感觉较好的方法。%Objective To report the clinical application of repairing skin defect on dorsum of multi finger with free multi-petal dorsalis pedis flap based on a single pedicle. Methods From March 2009 to May 2013, 4 cases (8 fingers) were used unilateral dorsum pedis bifoliated flap; 3 cases (9 fingers) were used unilateral dorsum pedis trilobed flap;2 cases (8 fingers) were used bilateral dorsum pedis bifoliated flap. The flap size ranged from 2.0 cm×3.0 cm to 3.0 cm × 8.0 cm. Results 7 cases (21 fingers) were followed-up from 6 to 24 months, the blood supply of the flaps were good and the texture and color of the skin were nearly normal, the flaps were a little bulky with satisfactory cosmetic results and good function. The extensor function was rebuilt, the flexion angle of the MP was 90°, and the sensation was recovered, two-points discrimination ranged from 8 to 12 mm. The function of the donor site were almost normal, and the gait and bounce were normal. Conclusion Free multi-petal dorsalis pedis flap based on a single pedicle is an ideal method to recover sensation and repair skin defects on dorsum of multi fingers.
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