趾甲延长术的临床应用  

Clinical experience of toenail lengthening

作　　者：张功林[1] 郭翱[1] 章鸣[1] 徐招跃[1] 张灵芝[1] 王顺炳 李俊[1] 吴发林 郁辉 

机构地区：[1]台州骨伤医院(原温岭骨伤科医院)手外科中心,浙江温岭317500 [2]江苏大丰市同仁骨科医院

出　　处：《实用手外科杂志》2007年第2期77-79,F0003,共4页Journal of Practical Hand Surgery

摘　　要：目的总结趾甲延长术在第二足趾游离移植再造拇(手)指的临床应用经验。方法用这种方法对12例(男9,女3)第二足趾移植再造拇(手)指的患者进行了趾甲延长术。其中,拇指10例,食指2例。病人年龄18～46岁,平均25岁。在再造指距甲根皮缘0.5cm处,去除一块矩形皮肤,勿损伤皮下血管网。其高度0.2cm,宽度与趾甲相等,将U形皮瓣向近端柔和推剥并缝合。结果1例术后供区发生表浅感染,经交换敷料逐渐愈合。再造的拇(手)指全部成活,术后经过顺利,随访7个月～2年(平均13个月),趾甲外形较好,取得较满意的临床效果。结论在第二足趾游离移植再造拇(手)指中应用趾甲延长术,可延长趾甲2～3mm,改善了再造拇(手)指的外形,没有发生甲生长畸形,是一种简单有效的手术方法。Objective To summarize clinical application experience of the toenail lengthening in free second toe transfer for reconstruction of the thumb （finger）. Methods Twelve patients（9 men, 3 women ） of reconstruction of the thumb （finger） with second toe transfer underwent the toenail lengthening by this technique. Of them, 10 cases were the thumb and 2 cases the index finger. The ranged age from 18 to 46 years （mean 25y）. A skin rectangle was resected at a distance of 0.5cm from the eponychium, with care taken to leave the underlying subcutaneous vascular network intact. It was 0.2cm high and as wide as the toe nail. Then U shape flap was delicately slid proximally and its ends sutured.Results One case sustained superficial infection postoperative at donor site and the wound healed by daily wound dressings All the thumb （finger）of reconstruction had survived completely and the postoperative course was uneventful. At 7 to 24 months （mean 13 months） follow up, the appearance of the nail was good, with satisfactory clinical results. Conclusion Using toenail lengthening in free second toe transfer for reconstruction of the thumb （finger）,a toenail of length of 2-3mm is obtained, the appearance is improved, with no toenail growth deformity. This is a simple and effective method of operation.

关 键 词：趾甲 再造 拇(手)指 

分 类 号：R658.2[医药卫生—外科学]