第二足趾游离移植再造小儿手指

目的 总结第二趾游离移植再造小儿手指的临床效果,评价术后对足部功能及外观的影响.方法 2002年6月至2010年5月采用第二足趾游离移植亚急诊再造小儿手指16例,其中再造拇指2例、示指8例、中指6例.术后经12～24个月随访,分析再造手指的功能情况.结果 16例手术再造手指均获得成活,1例术后发生血管危象,经重新吻合血管后成活.1例供区足部植皮部分坏死,换药后瘢痕愈合.全部再造手指生长发育良好,外形正常,对指、对掌功能良好,两点分辩觉6～ 10mm.再造指抓握力量好.供足步态正常,无疼痛不适,足部功能影响不大.结论 用第二足趾游离移植再造修复小儿手指缺损可获得满意的再造效果,对足部外观及功能无明显影响.

Clinical experience of finger reconstruction in child with second toe transplantation

Objective To investigate the clinical efficacy of finger reconstruction in child with second toe transplantation,and evaluate the postoperative appearance and function regarding the reconstructed donor feet.Methods From June 2002 to May 2011,sixteen cases were reconstructed in sub-emergency with second toe transplantation.Two thumbs,eight index fingers,and 6 middle fingers were reconstructed.All patients were followed-up from 12 to 24 months.The functions of reconstructed fingers were analysed.Results All the reconstructed fingers survived.Vascular crisis occurred in 1 patient,and survived after re-anastomosis.Necrosis of skin grafts at the domon site with exposed tedons was seen in 1 ease,and healed after changing dressings.All the reconstructed fingers showed good in growth and development,and performed good functions as grabbing,grasping and nipping.Two-point discrimination was between 6 mm and 10 mm.The donor site of the foot had normal gait,without obvious influence on walking.Also,no pain was complained.Conclusion The method of transplanting the second toe can reconstruct the appearance and function of the finger defects in child,and has little effect on the appearance and motion of feet.It is an effective treatment method.