足拇趾残端缺损的显微外科修复  

Repairing of the tip defect of the great toe with microsurgery

作　　者：王海峰[1,2] 方健 赵光勋[1,2] 甘正祥[1,2] 裴少保[1,2] 

机构地区：[1]安徽医科大学解放军临床学院 [2]解放军第105医院显微骨科,安徽合肥230031

出　　处：《临床骨科杂志》2009年第6期661-663,共3页Journal of Clinical Orthopaedics

摘　　要：目的探讨足拇趾残端缺损的修复方法及临床疗效。方法应用5种皮瓣修复39例足拇趾残端缺损,其中足底内侧岛状皮瓣8例,第1跖背动脉岛状皮瓣9例,跗内侧岛状皮瓣11例,跗外侧岛状皮瓣5例,静脉皮瓣6例。皮瓣切取面积2.5 cm×3.5 cm^5 cm×7 cm。结果33例带蒂岛状皮瓣中完全成活32例,1例足底内侧岛状皮瓣发生部分坏死,换药后愈合,皮瓣质地柔软,外形良好。6例游离皮瓣中5例完全成活,1例术后早期呈暗紫红色,肿胀,有散在水疱,2周后皮瓣颜色、外观逐渐恢复正常。34例获随访,时间10个月~3年,患肢行走功能正常,皮瓣不臃肿,质地柔软,保护性感觉部分恢复,耐摩擦、耐压,无皮肤破溃发生。结论足拇指残端创面修复的皮瓣种类较多,应根据临床具体情况选择合适的皮瓣,可达到较满意的修复效果。Objective To evaluate the clinical effect of repairing the tip defect of the great toe.Methods The tip defect of the great toe in the 39 cases were repaired by 5 types of skin flaps,including 8 cases of the medial plantar island flap,9 cases of the first dorsal metatarsal artery island flap,11 cases of the medial foot island flap,5 cases of the lateral foot island flap,6 cases of the arterialized venous flap.The flaps ranged from 2.5 cm×3.5 cm to 5 cm×7 cm in size.Results In the 39 cases of skin flaps,there are 37 completely survived cases,1 partly necrotized case and 1case with a dark purple skin,blisters in part of the flap.34 cases were followed up for 10 months3 years.The flaps were good in texture,color and thickness.Sensation was recovered partly.Conclusions The kinds of skin flaps repaired for the tip defect of the great toe increase and the suitable flaps can be chosen according to the clinic to get satisfactory repairing effect.

关 键 词：拇趾/损伤 外科皮瓣 

分 类 号：R683.42[医药卫生—骨科学] R622.12[医药卫生—外科学]