游离坶甲瓣移植术后对供足功能的影响

游离甲瓣移植再造拇指已成为拇指缺损的主要治疗方法之一，但供足功能影响问题未能引起人们的重视。随访了１９８３年～１９９２年间１０７例中的６２例甲瓣移植病人。发现供足功能正常者为４２例（６７．７％）；有一般症状，如残端痛，破溃等１２例（１９．４％）；供足有较严重功能影响者为６例（９．７％）；有继发足疾患２例（３．２％）。分析了甲瓣切取对前足结构损伤的关系，前足负重点改变，以及供足继发性疾病的原因。提出重视甲瓣切取后足结构的修复，严格手术适应证选择等，将供足功能影响减少到最小程度。

ABSTRACTSFUNCTONAL RESULTS OF THE DONOR FOOT AFTER FREE WARPAROUND FLAP

linically,free neurovascular warparound flap big toe is generally used as one of the methods forthe reconstruction of thumb. The fate of the donor foot , and the various problems brought about bythe transfer, however, had not drawn enough concentration from the surgeons.Free warparound flap transfer was performed on 107 patients and 62 cases of the total werefollowed-up. It was found that the results of the transfer were generally satisfactory to the thumb,but much were complained about the affected feet. The author had made a statistical analysis of theproblems of donor feet as follows:Normal(weight carrying and gait):42 cases(67.7%)Slightly abnormal(pain or ulcer):12 cases(19.4%)Serious troubles(trouble in wailking):6 cases(9.7%)Secondary symptems(plantar painful,calbeity,and plantar aporoneurcaits):2 cases(3. 2%)The analysis was focused on the influences of warparound flap to the construction of the fore-foot, the change of loading point after operation , and the eausative factors of secondary symptems ofthe donor foot. In order to minimiz the functional influeuce on the donar foot after oporation, it wasnecessary to adhere strictly to the indications.