Objective To observe the curative effect of mid-terminal dorsal fascia flap and skin grafting on the repair of nail bed defect. Methods Retrospective analysis of 17 cases with a ring nail nail bed necrosis and defect who underwent middle finger[] artery end dorsal perforation fascia flap + skin graft repair,fascia flap for direct suture from June 2013 to March 2016 was performed. Results 17 cases of skin were survived and the incisions were the first stage of healing. They were all followed up for 3 to 24 months,an average of 16 months. One case had wound fascia flap repair swelling and residual armor growth after 3 months later,wound healed after re-operation to remove residual arm. The other fascia flap + skin graft shape satisfaction,soft texture,not bloated,for the area only left a linear scar. Conclusion The midpoint of the infarcted dorsal metacarpal fascia flap and the skin graft repair the nail bed defect,and the damage to the donor area and hand shape is small,which is in accordance with the principle of hand wound repair. Blood supply is reliable and not destroy the important blood vessels,simple operation,low risk of surgery,good appearance to meet the requirements of patients is to repair nail bed defects,necrosis better treatment.%目的 观察中节指动脉终末背侧筋膜瓣+植皮修复甲床缺损的疗效.方法 回顾性分析2013年6月至2016年3月17例示中环小指甲床坏死、缺损患者采用中节指动脉终末背侧穿支筋膜瓣+植皮修复,筋膜瓣供区直接缝合.结果 术后17例皮片均成活,供区切口均Ⅰ期愈合.随访3～24个月,平均16个月.其中1例术后3个月创面筋膜瓣修复处红肿,有残甲生长,再次手术去除残甲,术后创口愈合良好.其余筋膜瓣+植皮处外形满意,质地柔软,不臃肿,供区仅遗留线性瘢痕.结论 中节指动脉终末背侧穿支筋膜瓣+植皮修复甲床缺损,对供区和手的外形损伤小,符合手部创面修复原则.血供可靠,不破坏重要血管,操作简单,手术风险低,外观良好,满足患者要求,是修复指甲床缺损、坏死较好的治疗方法.
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