摘要
目的 探讨移植■趾趾尖再造外伤后指尖缺损的临床疗效及选择不同方式修复足部供区的优缺点。方法 收集2021年1月-12月收治的8例指尖缺失患者的临床资料,根据指尖缺损的部位、大小、类型及外形等为设计依据,游离带部分趾骨和■趾甲床腓侧复合组织再造缺损指尖,分别将游离的■趾趾尖的腓侧趾底动脉、神经与手指优势侧固有动脉、神经相接合,趾尖复合组织携带的静脉与指背侧静脉相吻合。足部供区修复有四种方式,其中残端修整3例,植皮2例,第2趾胫侧移植修复1例,腹股沟皮瓣移植修复2例。观察再造指尖的外形、成活和指尖的功能、感觉恢复情况,以及足部供区的愈合情况。结果 对再造指尖进行6~12个月随访观察,8例再造指尖全部成活,再造指尖外形、颜色及功能恢复近似正常。足部供区采用残端修整、第2趾胫侧皮瓣及游离腹股沟皮瓣移植修复等方式获得良好的愈合效果,供区的手术瘢痕较小,无明显的瘢痕挛缩,足部也有较好的功能。其中1例采用植皮修复供区足部植皮区域部分皮片坏死,定期换药后达到临床愈合,但形成明显瘢痕。以上足部行走功能正常。结论 游离■趾趾尖复合组织移植再造外伤后缺损指尖是一种较为理想的手术方式,再造指尖的外形及功能近似正常。采用残端修整、第2趾胫侧皮瓣及游离腹股沟皮瓣移植修复足部供区可获得良好的效果。
Objective To explore the advantages and disadvantages of the fingertips after transplanting the tip of the great toe tip to the fingertip after the trauma defect.Methods Eight patients with a loss of fingertips from January 2021 to December 2021,of which 6 were single finger defects,1 case was thumb,showing fingertips defects,1 case as thumb,and ring fingertips.The design basis according to the parts,size,type and shape of the fingertip defect,as the design basis,the free toe tip of the toe tip of the toe of the toe with some toe with some toe of the toe of the toe of the toe with some toe the bottom arteries,nerves were inherently inherent in the side of the fingers,and the nerves were consistent with the veins carried by composite toe composite tissue with the back side veins of the finger.There were four ways to repair the feet,including 3 cases of residual end,2 cases of skin graft,1 case of second-toe tibia transplantation,and 2 cases of groin leather petals transplanted.Function,feeling recovery,and healing of the foot supply area was observed.Results Patients with recreation fingertips were observed for 6~12 months.All 8 re-created fingertips survived,and the recovery of fingertips,color and function recovery were approximately normal.The feet supply area adopted residual end repair,second toe tibial skin flap,and free-groin-groin peeling flap transplantation repaired and other methods.Good features.One case was necrotic in some leather tablets in the leather-implanted area in the feet in the feet in the area of the leather-implanted supplies.The regular changes in the later period achieved clinical healing,but it formed obvious scars;the above foot walking function was normal.Conclusion The fingertip after the transplantation of the tip of the toe toes is a more ideal surgical method after the transplantation of the trauma. The residual end repair, the second toe tibi side skin, and the free -stroke -groin skin petal transplantation repair the foot supply area can achieve good results.
作者
潘震
唐阳平
苗峰
刘少东
PAN Zhen;TANG Yangping;MIAO Feng(Department of Hand Surgery,China Railway Fuyang Hospital,Fuyang,Anhui,236100,China)
出处
《实用手外科杂志》
2023年第4期519-522,共4页
Journal of Practical Hand Surgery
关键词
指尖缺损
指尖再造
■趾
游离腹股沟皮瓣
足趾移植游离皮瓣
Fingertip defect
Fingertip reconstruction
Toe
Free inguinal skin flap
Toe transplantation free flap
