吻合血管的第二跖趾关节游离移植置换第二掌指关节11例

目的总结吻合血管的第二跖趾关节游离移植置换第二掌指关节的临床经验。方法手术时切除破坏的第二掌指关节及部分第二掌骨和近节指骨，将第二跖趾关节转移至手部第二掌指关节处，在鼻烟窝处将足背动脉与桡动脉吻合、大隐静脉与头静脉吻合，将切除的第二掌指关节的软骨关节面和骨骼的软组织剔除后回植到足部第二跖趾关节供区。结果临床应用11例，其中8例于术后5个月-2年6个月得到随访，第二掌指关节均获得较良好的功能恢复。结论吻合血管的第二跖趾关节游离移植置换第二掌指关节，能有效地恢复第二掌指关节的功能。

Replacement of damaged second metacarpophalangeal joint with pedicaled second metatarsophalangeal joint: 11 cases report

Objective To summarize the clinical experience in the replacement of the damaged second metacarpophalangeal joint with the second metatarsophalangeal joint with a pedicle of dorsal pedis artery and great saphenous vein. Methods The damaged second metacarpophalangeal joint, distal part of the second metacarpal and proximal part of the proximal phalanx were dissected. The metatarsophalangeal joint was transferred to the region of metacarpophalangeal joint of hand. The dorsal pedis artery was anastomosed to the radial artery, and the great saphenous vein was anastomosed to the cephalic vein at anatomical snuff-box. The dissected bones of the hand removed of the cartilage of joint and soft tissue were grafted back to the donor site of the foot. Results A 5 - 30 month follow-up study in 8 out of 11 cases showed that satisfactory functional recovery was achieved in clinical practice. The movement of second metacarpophalangeal joint was excellent. Conclusion The function of the second metacarpophalangeal joint can be effectively recovered by the transfer of the vascularized second metatarsophalangeal joint.