改良跖趾关节游离移植置换掌指关节的临床应用

目的总结改良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14例，其中12例于术后5个月～3年2个月得到随访，第二掌指关节均获得较好的功能恢复。结论改良的第二跖趾关节游离移植置换第二掌指关节术式，能有效地恢复第二掌指关节的功能。

Clinical application and effective analysis of replacement of damaged metacarpophalangeal joint with metatarsophalangeal joint

Objective To summarize the clinical experience in the improved replacement of the damaged second metacarpophalangeal joint with the second metatarsophalangeal joint with a pedicle of dorsal pedis artery distal part of the metatarsophalangeal and great saphenous vein. Methods The damaged second metacarpophalangeal joint, second metacarpal and proximal part of the proximal phalanx were dissected.The 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 snuf-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 5-38 month follow-up study in 12 out of 14 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 improved transfer of the vascularized second metatarsophalangeal joint.