Ⅰ期趾甲延长术9例报告

目的:总结Ⅰ期在第2足趾游离移植再造拇(手)指中行趾甲延长的临床应用经验.方法:采用趾甲延长方法对9例(男7,女2例)第2足趾移植再造拇(手)指的患者进行了趾甲延长术,其中拇指8例,食指1例.年龄18～46岁,平均25岁.在再造指距甲根皮缘5 mm处,去除1块矩形皮肤,勿损伤皮下血管网.其高度2 mm,宽度与趾甲相等,将U形皮瓣向近端柔和推剥并缝合.结果:1例术后供区发生表浅感染,经换敷料逐渐愈合.再造的拇(手)指全部成活,可延长趾甲2～3 mm,改善了再造拇(手)指的外形,无指甲生长畸形发生.随访7个月～2年(平均13个月),趾甲外形较好.结论:在第2足趾游离移植再造拇(手)指中应用Ⅰ期趾甲延长术,使趾甲从短小向纵向延长,缩小手指甲与足趾甲之间差异,能改善再造拇(手)指甲外形,且不影响再造指的活动功能,是一种简单有效的手术方法.

One-stage toenail lengthening:a report of 9 cases

Objective: To summarize clinical application of one-stage toenail lengthening in free second toe transfer for reconstruction of the thumb(finger). Methods: Nine patients(male 7,female 2)underwent thumb(finger)reconstruction with second toe transfer were treated by one-stage toenail lengthening technique. Eight were the thumb and 1 was the index finger. Patients aged from 18 to 46 years,with an average of 25 years. A rectangle skin was resected at 0.5 cm away from the eponychium,which was 0.2 cm high and as wide as the toenail. Then stripped U shape flap gently towards proximal end and sutured it. During the operation,the injury of the subcutaneous vascular network should be avoided. Results: Superficial infection at donor area happened in 1 case and was healed by changing dressings. All the reconstruction thumbs(fingers)had survived completely. 2 to 3 mm extending of toenail length was obtained and the appearance of thumb(finger)was improved. There was no growth deformation of toenail. After 7 to 24 months follow up(the average time 13 months),the appearance of t- he nail was good. Conclusion: One-stage toenail lengthening in free second toe transfer for reconstruction of the thumb(finger),which can obtain a satisfactory appearance of the nail and have no influence on the motion of the reconstruction thumb(finger),is a simple and an effective operative procedure.