足趾游离小组织块移植修复手指部分缺损

目的探讨采用不同类型的足趾游离小组织块移植修复手指部分缺损的临床效果。方法我院自2006年3月至2012年9月分别应用吻合血管的趾腹皮瓣、甲皮瓣、重建末节指骨的甲瓣、趾腓侧半复合组织瓣及第2足趾节段5种类型游离小组织块移植修复手指部分缺损25例患者。结果手术均获得成功,经6个月~5年(平均2.5年)随访,患指指间关节活动度平均为52,指腹饱满,外形逼真,耐磨,指甲生长良好,两点分辨觉为4~7 mm,供区行走良好,无疼痛及足部肿胀,植皮处肤色深,关节活动无影响。结论以足趾为供区的不同类型游离小组织块移植是修复手指部分缺损的较佳方法之一。

Isolated tissue blocks transplantation of toe in repairing finger defects

Objective To investigate the effect of repaired partial loss of thumb and finger with five kinds of free flap or compound flap from toe donor. Methods From March 2006 to September 2012, 25 cases with five types of partial thumb and finger loss were repaired with free transplantation of pulp flap, wrap around flap, osteo - onychocutaneous flap, fibular segmentalosteo - onychocutaneous flap of the great toe and partial compound flap of the second toe. Results All survived and the mean follow - up period was 9.5 years （0.5 ～ 5 years）. An average of 52 degrees of range of motion of interphalangeal joint was achieved. The two- point discrimination was 4 ～ 7mm, and the appearance of repaired thumb and finger was excellent. Conclusion The transplantation of five kinds of free flap and compound flap from the toe is the optimal way to repair partial defect of thumb and finger.