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足趾移植拇指与手指再造的临床研究
引用本文:杜昭,黄德征,官英勇,蔡文. 足趾移植拇指与手指再造的临床研究[J]. 实用手外科杂志, 2009, 23(3): 147-150. DOI: 10.3969/j.issn.1671-2722.2009.03.008
作者姓名:杜昭  黄德征  官英勇  蔡文
作者单位:玉林市第一人民医院,手外科,广西,玉林,537000
摘    要:目的探讨足趾移植拇指与手指再造的方法和疗效。方法采用部分坶趾移植拇指部分再造22例,躅甲瓣或带足背皮瓣船甲瓣移植拇指再造13例,第2足趾移植再造拇指4例,再造手指3例,及带足背皮瓣的第2足趾移植再造拇指7例,带足背皮瓣的第2,3足趾移植再造手指7例,带足背皮瓣的躅甲瓣或第2趾和第2,3趾组合移植再造拇手指10例,双足第2足趾移植全手缺失二指再造2例,共68例97指。结果再造拇手指和皮瓣全部成活,成活率为100%,术后经3月~10年的随访和信访,按中华医学会手外科学会拇、手指再造功能评定试用标准评定:优62指,良24指,可9指,差2指,优良率达88.66%。结论采用部棚趾、第2足趾棚甲瓣移植再造拇手指,带足背皮瓣的躅甲瓣、第2趾或第2,3趾组合移植行合并手部皮肤缺损的拇手指再造,效果满意。

关 键 词:足趾移植  拇指  手指  再造

Clinical research of thumb and finger reconstruction with toe transplantation
Affiliation:DU Zhao, HUANG De-zheng, GUAN Ying-yong, et al (Department of Hand Surgery,The First People's Hospital of Yulin City, Guangxi, Yulin, 537000, China)
Abstract:Objective To investigate the method aind effect of thumb and finger reconstruction with toe transplantation.Methods Reconstruction of partial defect of thumb by partial transplantation of distal toe tissue from the great toe were 22 cases, tkeconstruction of thumb by transplantation of first toe and nail flap or first toe and nail flap with foot back flap were 13 cases.Transfer of second toe was used to reconstruct thumb in 4 cases,reconstruct finger in 3 cases,Transfer of second toe with foot back flap was used to reconstruct thumb in 7 cases. Transfer of second and third toe with foot back flap was used to reconstruct finger in 7 cases. Transfer of first toe and nail flap or second toe and second and third toe with foot back flap was used to reconstruct thumb finger in 10 cases. Transfer of second toe of both feet was used to reconstruct two finger for patients with full hand defect in 2 cases.It contained 68 cases 97 fingers.Resnits All reconstructed fingers survived,The survival rate was 100%.For following-up 3 months to 10 year,The result was graded as excellent in 62 fingers, good in 24,fair in 9, poor in 2. The excellent and good rate was 88.66% according to the upper limb functional evaluation criteria issued by the hand surgery society of the chinese medical association.Conclusion To reconstruct thumb and finger for patient with hand skin defect, satisfactory results can be achieved by method of transplantation of partial first toe or second toe and first toe and nail flap,transfer of first toe and nail flap or second toe and second and third toe with foot dorsum flap.
Keywords:Toe transplantation  Thumb  Finger  Reconstruction
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