足趾移植长手指全形再造术的临床应用

目的探讨足趾移植长手指全形再造手术的临床疗效。方法自2015年6月至2019年6月,对16例因外伤致手指缺损患者采用足趾移植长手指全形再造术,术后评估供区及受区的感觉功能、运动功能及外观形态,分析指甲畸形及增生性瘢痕的发生情况,并记录术后发生感染、血肿、皮片坏死及供区愈合不良等情况;通过调查问卷的方式分析患者的满意度。结果所有患者术后获随访1~12个月,其中2例受区发生感染,1例受区皮片边缘发生坏死,经换药后予以缓解;其余患者的供、受区均未出现长时间的痛疼感觉,受区感觉功能恢复达87.50%,受区运动功能恢复均较满意,手指外形基本满意。供区感觉受影响者2例,运动功能受限者1例,外形一般者2例。所有患者无指甲畸形及增生性瘢痕发生;满意者1例,基本满意者14例,不满意者1例。结论采用足趾移植长手指全形再造手术,基本可以满足患者及医师对于缺损手指进行完美修复的目标。

Clinical application of toe transplantation in the full-shaped reconstruction of full-length finger

Objective To explore the clinical efficacy of toe transplantation in the full-shaped reconstruction of full-length finger. Methods From June 2015 to 2019, 16 patients with finger defects caused by trauma underwent toe transplantation for full-shaped reconstruction of full-length finger. After the operation, the sensory function, motor function and appearance of donor and recipient site were evaluated. The occurrence of nail deformity and hypertrophic scar was analyzed. The adverse reactions such as infection, hematoma,skin necrosis and poor healing of donor site were recorded. The satisfaction degree of patients was analyzed by questionnaires. Results All patients were followed up from 1 to 12 months. Infection of recipient site was occurred in 2 patients. Necrosis at the edge of skin graft of the recipient site was occurred in 1 patient and relieved after dressing change. The remaining patients had no long-term pain sensation in the donor and recipient site. The recovery of sensory function of the recipient site was 87.50%, the recovery of motor function of the recipient site was satisfactory and the appearance of the finger was basically satisfactory. The sensation of donor site was affected in 2 patients, the motor function was limited in 1 patient and the general appearance existed in 2 patients. There was no nail deformity and hypertrophic scar occurred in all patients. One patient was satisfied with the operation, 14 patients were basically satisfactory and 1 patient was not satisfied with the efficacy. Conclusion The application of toe transplantation in the full-shaped reconstruction of full-length finger could basically achieve the goal of perfect repair of finger defects.