游离足趾和甲瓣移植再造拇手指42例

目的：介绍临床应用游离足趾、甲瓣移植再造拇手指的实践经验。方法：１９８８年起，应用游离足趾、甲瓣及姆甲瓣加第２跖趾关节联合移植等多种方法，再造拇手指４２例４５指。结果：除１例失败外，其余全部成活，成活率达９８％（４４／４５）。 ２３例经 １～２年随访，患者对再造拇手指的运动、感觉和外形，自我满意率达７８．３％（１８／２３）。结论：在选择再造拇指的术式时，如游离足趾、甲瓣、跖趾关节或带足青复合组织瓣移植等，应考虑到缺损手指数目、残端条件及工作性质等综合因素后，才能作出合理的手术方案。

Free toe and wrap-around flap transfer to reconstruct thumbs and fingers

We report our experiences of free toe and wrap-around flap transfer in thumbs and fingers reconstruction. Since 1988, free toe, wrap-around flap and second metatarsophalangeal joint transplantation has been used to reconstruct 45 thumbs and fingers in 42 patients. All but one case were successful. The rate of success was 98%. The successful rate of motion, sensation and contour of the reconstructed digits was 80% after follow-up of 1-2 years in 23 patients. The number and condition of the defective fingers and the working demand of patients should be considered in choosing surgical methods.