应用足趾侧方游离皮瓣移植修复手指软组织缺损

目的探讨足趾侧方游离皮瓣修复手指软组织缺损的临床疗效。方法采用足趾侧方皮瓣游离移植修复42例手指皮肤缺损患者(54指)。10例采用足拇趾腓侧游离皮瓣,13例采用第2趾胫侧游离皮瓣,5例采用第3趾胫侧游离皮瓣,2例采用第4趾胫侧游离皮瓣,12例相邻2指皮肤缺损采用拇趾腓侧、第2趾胫侧游离皮瓣联合移植。结果术后皮瓣全部成活。患者均获随访,时间5～16个月。皮瓣血运、质地、弹性及手指外形良好。皮瓣两点分辨觉达5～10 mm。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40指,良11指,差3指,优良率为94%。结论足趾皮瓣游离移植修复手指特定部位皮肤缺损疗效理想。

Free toe-side flaps for reconstruction of cutaneous deficiency of thumbs and Fingers

Objective To explore the clinical effects of free toe-side flap grafting for reconstruction of cutaneous deficiency of thumbs and fingers.Methods 42 cases(54 fingers) of cutaneous deficiency of thumbs and fingers were reconstructed by transplantation of free toe-side flaps.10 cases were reconstructed by free flap of fibular side of the great toe,13 cases were reconstructed by free flap of tibial side of the second toe,5 cases were reconstructed by free flap of tibial side of the third toe and 2 cases were reconstructed by free flap from tibial side of the fourth toe.12 cases of cutaneous deficiency of two neighboring fingers were reconstructed by free combination flap of fibular side flap of the great toe and tibial side flap of the second toe.Results The surgery succeeded in all 42 cases with average follow-up for 5~16 months.The blood supply,texture,elasticity of the transferred flaps and the appearance of fingers were excellent.The two point discrimination of the flaps were 5~10 mm.According to Hand Surgery Society of Chinese Medical Association standard for functional evaluation of upper limb,the results were excellent in 40 fingers,good in 11,and poor in 3,the excellent and good rate was 94%.Conclusions Transplantation of free toe-side flaps is an ideal method for reconstruction of cutaneous deficiency of thumbs and fingers.