Ⅰ期趾甲延长术9例报告  

One-stage toenail lengthening:a report of 9 cases

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

机构地区：[1]温岭市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：《中国骨伤》2008年第1期47-48,共2页China Journal of Orthopaedics and Traumatology

摘　　要：目的:总结Ⅰ期在第2足趾游离移植再造拇(手)指中行趾甲延长的临床应用经验。方法:采用趾甲延长方法对9例(男7,女2例)第2足趾移植再造拇(手)指的患者进行了趾甲延长术,其中拇指8例,食指1例。年龄18～46岁,平均25岁。在再造指距甲根皮缘5mm处,去除1块矩形皮肤,勿损伤皮下血管网。其高度2mm,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,经换敷料逐渐愈合。再造的拇(手)指全部成活,可延长趾甲2～3mm,改善了再造拇(手)指的外形,无指甲生长畸形发生。随访7个月～2年(平均13个月),趾甲外形较好。结论:在第2足趾游离移植再造拇(手)指中应用Ⅰ期趾甲延长术,使趾甲从短小向纵向延长,缩小手指甲与足趾甲之间差异,能改善再造拇(手)指甲外形,且不影响再造指的活动功能,是一种简单有效的手术方法。Objective：To summarize clinical application of one-stage toenail lengthening in free second toe transfer for reconstruction of the thumb（finger）. Methods：Nine patients（male 7 ,female 2）underwent thumb （finger）reconstruction with second toe transfer were treated by one-stage toenail lengthening technique. Eight were the thumb and 1 was the index fin- ger. Patients aged from 18 to 46 years,with an average of 25 years. A rectangle skin was resected at 0.5 cm away from the eponychium,which was 0.2 cm high and as wide as the toenail. Then stripped U shape flap gently towards proximal end and sutured it. During the operation, the injury of the subcutaneous vascular network should be avoided. Results：Superficial in- fection at donor area happened in 1 case and was healed by changing dressings. All the reconstruction thumbs（fingers）had survived completely. 2 to 3 mm extending of toenail length was obtained and the appearance of thumb（finger）was improved. There was no growth deformation of toenail. After 7 to 24 months follow up（the average time 13 months）,the appearance of t- he nail was good. Concluslons：One-stage toenail lengthening in free second toe transfer for reconstruction of the thumb （fin- ger） ,which can obtain a satisfactory appearance of the nail and have no influence on the motion of the reconstruction thumb （finger）, is a simple and an effective operative procedure.

关 键 词：趾甲 再造 拇(手)指 

分 类 号：R687.3[医药卫生—骨科学] R658.1[医药卫生—外科学]