摘要
目的探讨吻合趾-指血管的足趾移植拇、手指再造的临床效果。方法2009年4月至2013年4月，本院收治拇、手指缺损166例，其中：Ⅰ°-Ⅲ°拇指缺损46例、Ⅰ°—Ⅴ°手指缺损120例，实施吻合趾．指血管足趾移植急诊再造62例，亚急诊再造104例，术后早期行功能康复。结果再造166例208指全部成活。随访4～24个月，平均11个月，所有再造拇、手指血运丰富，外形与正常拇、手指类似，痛、温觉恢复良好，两点辨别觉6～10m／n，关节活动度基本正常，对指和对掌灵活，大部分患者对再造拇、手指外形感到满意，恢复了术前的生活和工作能力。供区无明显不适，行走和负重功能正常。结论对于拇指Ⅰ°-Ⅲ。和手指Ⅰ°-Ⅴ°外伤性缺损的患者，吻合趾-指血管的足趾移植拇、手指急诊及亚急诊再造临床效果良好，且对供区损伤小。
Objective To discuss the clinical effect of thumb and fingers reconstruction with vascular anastomosis transplantation from toes. Methods From April 2009 to April 2013, 166 cases of thumb and finger defect were treated, including 46 cases Ⅰ°-Ⅲ° thumb defect and 120 cases Ⅰ°-Ⅴ° finger defects. Sixty-two cases were emergency reconstructed by vascular anastomosis transplantation from toes, the other 104 cases were subemergency reconstructed. Early functional rehabilitation was carried out postoperative. Results All 208 thumb and fingers in 166 cases with these procedures were survived. Patients were followed up from 4 to 24 months, averaged of 11 months. The reconstructed thumb and fingers were all with abundant blood supply, having similar shape to the normal thumb and fingers, good pain and temperature sensation, with two-point discrimination of 6-10 mm, with normal range of joint activity, flexible function of finger to finger and finger to palm. Most patients were satisfied with the thumb and finger shape, regained life and work ability as before. The donor sites had no obvious discomfort, and walking and weight-bearing function remained normal. Conclusion For patients with thumbs Ⅰ°-Ⅲ° and fingers Ⅰ°-Ⅴ°degree of traumatic defect, emergency and subemergency reconstruction of fhumb and fingers by vascular anastomosis transplantation from toes have good clinical effect and less damage to the donor site.
出处
《中华显微外科杂志》
CSCD
北大核心
2014年第3期229-232,共4页
Chinese Journal of Microsurgery
关键词
拇指
手指
再造
显微外科
Thumb
Finger
Reconstruction
Microsurgery
