摘要
目的探讨解决先天性或创伤所导致的残缺手与手指骨缺损、外形残缺和功能受限的问题，以及通过再造恢复其外形及功能的手术方法。方法采用自体游离或带血管髂骨与皮瓣组合、带血管跖趾关节或游离足趾与皮瓣组合等方法一期或分期再造残缺手与手指。用局部或游离皮瓣或串联皮瓣重建缺损的软组织，同时修复关节囊及肌腱缺损。结果术后除1例因严重感染失败，其余全部成活。15例中13例经8个月～2年随访，按照中华医学会手外科学会断指再植功能评定试用标准评价结果：运动功能优2例，良5例。感觉功能：优（S5）8例，良（S4）1例。外观评价：优4例，良5例。结论采用A体骨与皮瓣组合、自体足趾及关节移植与皮瓣组合等方法再造残缺手与手指。能最大程度的恢复手部外形及一定的功能，减低手和手指残缺率。
Objective To explore and solve the problem of insufficiency and malformation due to cripple hand and defect of digital bone resulted of innate and injured. Evaluation to the methods of bone autografting combinated with flaps to reconstruct the deficient hand and digits. Methods Vascularized iliac bone or metatarsophalangeal joints （MPJ） or toes transplantation incorporated with flaps were used to reconstruct the defected bone in palm or fingers. Combined with tendon absence in such cases should be repaired or restituted by tendon autografting in one stage or by stages. Results Total 16 cases were treated by the methods metioned above. Except 1 of 16 was failure resulted in severe infection, the others were reconstructed successfully. 13 of 16 were followed up 8 months to 2 years, the evalution of the group from motion,sensation and appearance shew that the fine rate of motion was 53.8 percent, the rate of appearance and sensation were both 69 percent. Conclusion Vascularized iliac bone or metatarsophalangeal joints （MPJ） or toes transplantation incorporated with flaps are available to reconstruct the defected bone in palm or fingers, and can reduce disability effectively while obtain a satisfactory outlook and proper functions by those methods.
出处
《中华显微外科杂志》
CSCD
北大核心
2009年第1期23-25,共3页
Chinese Journal of Microsurgery
关键词
指骨
掌
外科皮瓣
移植
Digital bone
Palm
Surgical flap
Transplantation
