拇手指部分缺损的修饰性修复与重建

目的评估对拇、手指末节部分缺损,选用相应部分足趾组织移植修饰性修复与重建的临床效果,提出修饰性修复与重建的新理念。方法对77例80指拇、手指末节半侧、背侧、指腹及手指部分复合组织缺损选用足趾末节半侧甲瓣,背侧甲瓣,趾腹皮瓣及足趾相应部分复合组织移植,采用吻合趾．指动静脉重建血液循环,施行修饰性修复与重建。结果成活75例78指,成活率为97．5％,术后经半年至12年随访,保持了手指原来长度与外形,重建了指甲,使指腹饱满,具有罗纹,出汗,两点分瓣觉为4～6mm,获得较完美的外形与功能。结论对拇、手指末节部分复合组织缺损,选用相应部分足趾半侧甲瓣、背侧甲瓣、趾腹皮瓣及复合组织移植的修饰性修复与重建,可达到精细修复效果和修饰性修复与重建的目的。

Decorative repair and reconstruction of subtotal thumb and finger defect with trimmed toe flap transfer

Objective To summarize the new procedure for decorative repair and reconstruction of subtotal defect of thumb and finger with trimmed toe flap transfer. Methods Seventy-seven patients with 88 thumb and/or finger subtotal defect in the form of lateral half, dorsal half, pr volar half composite tissue defect were reconstructed with the lateral nail-skin flap, dorsal nail-skin flap, or pulp flap taken from the corresponding parts of toes. Blood circulation was re-established by anatomize the digital arteries of the toes and fingers. Follow-up was conducted for 6 months to 12 years. Result Seventy-eight in 77 cases survived with an overall survival rate of 97. 5%. The surviving fingers all preserved usual length, fine-looking appearance, with nail and full pulp, and normal functions, including sweating function and a two-pointdiscrimination of 4 -6 mm. Conclusion Better than any traditional toe-to-hand transfer, the procedure of repair and reconstruction of subtotal defect of thumb and finger with trimmed toe flap transfer not only restore the function of the wounded thumb and/or finger, but also help the objective of decoration.