摘要
目的研究双侧趾甲骨皮瓣重建拇与手指缺损的临床疗效。方法以健侧手指测量数据为依据，设计切取双足趾腓侧部分甲骨皮瓣，通过组合两个复合组织瓣重建拇、手指缺损。2008年3月至2015年12月，应用该方法再造拇、手指9例9指，缺损程度为Ⅰ°~Ⅲ°。术后通过对重建拇、手指和供区足部的外观、功能、感觉进行随访。讨论该方案临床应用的效果及安全性。结果重建的9例9指均成活，无血管危象发生。本组均获术后随访3个月~2年，所有重建拇、手指血供、外观及功能基本达到对侧健指水平，感觉恢复好，两点分辨觉达4~8 mm，患者对重建指及供区外形均满意，供区无影响，行走和负重功能正常。按中华医学会手外科学会上肢部分功能评定试用标准评价，优6指，良2指，可1指。结论双侧趾甲骨皮瓣拼接重建拇、手指，不但恢复了拇、手指的功能，而且满足了患者对供区及受区美观的要求。
Objective To investigate the therapeutic effect of bilateral combined flap transfer in reconstruction and repairation of thumb and finger defects. Methods A partial fibular side wrap-around flap was harvested from both big toes. The flaps were tailored and designed based on measurements taken from the finger of the intact side. These two flaps were combined to reconstruct the defects of the finger. From March, 2008 to December, 2015, a total of 9 fingers （9 cases） which had defect degrees range from Ⅰ ° to Ⅲ° underwent reconstruction surgeries in this way. Appearance, sensation and function of the thumb and foot flap were followed-up. Simultaneously how to improve the outcoming and success rate were explored and investigated. Results All 9 thumbs and fingers in 9 cases with these procedures were survived. No vascular crisis happened. All patients were followed up from 3 to 24 months. The reconstructed thumbs and fingers were all with abundant blood supply, having similar shape to the normal thumbs and fingers, good pain and temperature sensation, with two-point discrimination of 4-8 mm. All 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. Judged by the tentative evalution standard of function of upper limb, which was made by Chinese Medical Association for Surgery of the Hand. The results were excellent in 6, good in 2, fair in 1. Conclusion There is less damage on foot and most hand function recovery using bilateral combined flap transplantation to repair multiple fingers defect.
出处
《中华显微外科杂志》
CSCD
北大核心
2016年第5期424-427,共4页
Chinese Journal of Microsurgery
