保留足趾的趾关节游离移植修复手指关节缺损

目的为了修复外伤造成的手指关节（掌指关节、近节指间关节）缺损，介绍一种既能保留第2足趾．又能修复指关节缺损的带血管和皮肤及近节趾间关节的足趾骨瓣，并评价其疗效。方法对6例由外伤造成的指骨缺损合并指关节损伤患者，采用切取同侧中趾近节带皮肤、第2趾胫侧跖背动静脉、神经和近趾关节的骨瓣进行修复。皮瓣面积：1．0cm×2．0cm×1．5cm×3．0cm。结果6例指关节损伤全部修复，手指关节功能基本恢复正常，未见感染及关节坏死。结论带血管的第2足趾近节趾关节骨瓣修复外伤性指关节损伤，可以减轻患者手指功能障碍的痛苦，同时保留了第2足趾的外观形态，手术效果满意．切取方便．而且对供区足趾外形影响较小。

Repair of digital joint defect by transplanting toe joint with retaining toe

Objective To repair traumatic defect of digital joints （metacarpophalangeal joints, proximal interphalangeal joints）, here introducing a approach which can not only retain the second phalange of toe, but also repair defec phalangeal bone flap with blood vascular and skin, and estimate its effcacy. Methods 6 cases with phalange and joint defect, were caused by traumatic, incised ipsilateral middle phalangeal flap of toe with skin and dorsal metatarsal vascular and nerve. The flap＇area ranged from 1.0cm×2.0cm to 1.5cm×3.0cm. Results The 6 cases with phalangeal joint damage were rehabilitated completely. The function of phalangeal joints were essential in rehabilitation and none of infection and necrosis. Conclusion The vascularized bone flap of second proximal phallangeal joint of toe can relieve patient from phalangeal disfunction, and reserves appearance of second phalanges of toe simultaneously. It has satisfied surgery efficacy, convenient incision. In addition, it has no influence on donor site toe.