第三趾胫侧趾动脉皮瓣联合第二足趾移植改善再造手指外形  

Combined transfer of the second toe and tibial digital artery flap from the third toe to improve appearance of the reconstructed finger

作　　者：刘亚平[1] 程国良[1] 孙乐天[1] 王振军[1] 冯鹏[1] 

机构地区：[1]解放军第四0一医院全军手外科中心,青岛266071

出　　处：《中华手外科杂志》2010年第2期95-97,共3页Chinese Journal of Hand Surgery

摘　　要：目的探讨携带第三趾胫侧趾动脉皮瓣弥补第二足趾移植时因足趾趾腹膨大、趾体狭细而导致的外形缺陷。方法对9例10指拇、手指缺损的患者，在第二足趾移植再造拇、手指的同时，于第三趾胫侧设计并切取趾动脉皮瓣，嵌插于第二足趾中末节跖侧，增加第二足趾的周径使其接近正常拇、手指周径，同时修整趾腹，使再造拇、手指外形更接近正常。结果术后9例10指再造拇、手指全部存活，再造指中段周径增加了6-8mm，外形明显改善。结论第三趾胫侧趾动脉皮瓣血管恒定，切取方便，厚度适中；于第二足趾移植再造拇、手指时可一并切取，修饰第二足趾的外形，弥补再造拇、手指的外形缺陷。Objective To introduce a modified second toe-to-hand transfer procedure combined with a tibial digital artery flap from the third toe to correct the defects in appearance after toe-to-hand transfer due to the difference in natural shape between the second toe and the finger. Methods Nine patients with 10 thumb or finger defects were treated with the modified procedure. In reconstructing a finger or thumb with second toe transfer, a flap from the tibial side of the third toe was designed and transferred to the plantar side of the donor second toe in order to obliterate the eomtriction below the toe pulp. This flap shared a common blood supply with the second toe. Results All the reconstructed thumbs and fingers survived. The 6 to 8 mm increase in the circumferential at the mid-portion of the newly reconstructed fingers greatly improved the appearance of the fingers. Conclusion The tibial digital artery flap from the third toe has a constant vascular supply and adequate flap thickness. Flap harvest is straightforward and can be done simultaneously when harvesting the second toe. The flap corrects the shape of the second toe while combined with second toe-to-hand transfer for thumb or finger reconstruction.

关 键 词：指损伤 组织移植 显微外科手术 

分 类 号：R658.2[医药卫生—外科学]