第二足趾胫侧皮瓣治疗手指软组织缺损的临床分析

目的 探讨第二足趾胫侧皮瓣修复手指软组织缺损的方法和疗效.方法 自2006年起,应用第二足趾胫侧皮瓣游离移植修复手指软组织缺损30例.其中单侧第二足趾胫侧皮瓣移植21例,双侧第二足趾胫侧皮瓣移植5例,与同侧(母)趾腓侧皮瓣串联移植4例,皮瓣切取面积为6.0 cm×3.0 cm～2.0 cm×1.5 cm.结果 术后皮瓣全部存活.30例获得随访时间为6～12个月,皮瓣肤色红润,质地良好,手指外形及功能满意.按中华医学会手外科学会上肢部分功能评定试用标准评定,优良率达96%.皮瓣两点分辨觉达6～10 mm.结论 第二足趾胫侧皮瓣游离移植修复手指软组织缺损是一种理想的治疗方法.

Cliniral analysis of repairing finger parenchyma defect with free flap from tibial side of the second toe

Objective To explore the surgical technique and clinical outcomes of using free flap from tibial side of the second toe for coverage of finger parenchyma defects. Methods The free flap from tibial side of the second toe was transferred in 30 cases to repair finger parenchyma defect since 2006. Unilateral free flap from tibular side of the second toe was used in 21 cases, bilateral free flaps from tibular side of the second toes were used in 5 cases, and unilateral flap from tibial side of the second toe along with fibular flap from the great toe was transferred in 4 cases. The size of the flaps ranged from 6.0 cm × 3.0 cm to 2.0 cm× 1.5 cm.Results All the transferred free flaps survived. All 30 cases were follow-up for 6 to 12 months. The blood supply, texture, function and appearance of the repaired fingers were excellent. According to Hand Surgery Society of Chinese Medical Association standard for functional evaluation of the upper limb, the excellent rate was 96%. Two-point discrimination of the finger pulp was 6 to 10 mm. Conclusion Free flap from tibial side of the second toe for repairing parenchyma defect of fingers is an ideal method.