急诊一期组合组织移植再造手

目的:采用吻合血管组合组织移植一期修复手部大范围多元组织缺损再造手。方法:①指缺失:用第2足趾或躅甲瓣再造拇指,用第2、3足趾再造其它手指。②软组织缺损:虎口及手掌皮肤缺损用股前外侧皮瓣修复并同时用股前外侧皮神经重建受区感觉功能,大范围皮肤缺损则用股前外侧皮瓣组合其它皮瓣修复。③掌指关节及掌骨缺损:掌指关节缺失用跖趾关节重建,掌骨缺失用跖骨或髂骨重建。结果:33例75个游离组织全部成活,再造手功能恢复良好,皮肤感觉恢复。结论:吻合血管组合组织移植一期再造手,具有最大限度的保留手部残存非失活组织及功能,最大限度修复重建手部功能的优点,是理想的治疗方法。

PRIMARY RECONSTRUCT HAND BY COMBINED TISSUE TRANSPLANTATION

Objective:Primary repair large area and many race tissues defect of hand by com- bined tissue transplantation with vascular anscular anastomosis.Methods:1.Fingers defect:Thumb reconstract using second toe or wrap round flap,the other fingers reconstruct using second and third toes transplantation.2.Soft tissue defect:The skin of first web and palmar defect repair using antero- lateral femoral flap and sensory function of receive reconstruct using anterolateral cutaneous nevere, and large area defect repair using anterolateral femoral flap combined others flap.3.Metacarpopha- langeal joint and metacarpal bones defect:Metacarpophalangeal joint defect repair using metatarsopha- langeal joint,metacarpal bones defect repair using phalanx or lilac bone.Results:75 free tissues in 33 patients were survival,The outling and function of reconstruct hand was satisfactory,The sensation of the flaps recovered.Conclusion:Combined tissue transplantation was an ideal method for primary re- pairing large area and many race defect of the hand.