多个手指掌指关节平面缺损的再造  

Reconstruction of metacarpal joint plane defects of multiple fingers

作　　者：李建宁[1] 巨积辉[1] 王盛福[1] 金光哲[1] 刘跃飞[1] 李雷[1] 刘海亮[1] 侯瑞兴[1] 

机构地区：[1]苏州大学附属瑞华医院手外科,江苏苏州215104

出　　处：《实用手外科杂志》2012年第3期222-225,228,共5页Journal of Practical Hand Surgery

摘　　要：目的报道多个手指掌指关节平面缺损再造的临床疗效。方法2003年1月-2010年1月．采用吻合血管的游离双足第2趾及组织瓣移植，治疗多个手指掌指关节平面缺损患者23例．其中1—5指掌指关节缺损11例，2—5指掌指关节缺损12例。且12例伴有不同程度手掌、手背皮肤软组织缺损，缺损面积为3cm×5cm×12cm×15cm。23例患者共计再造32个手指。结果术后再造32指全部成活．1例足背植皮供区部分皮肤坏死，经换药后再次手术植皮创面愈合。经5-25个月（平均10个月）随访．再造手指恢复了抓、捏、对指等功能，再造指及皮瓣感觉恢复S2～S3＋，生活基本自理，、供区行走无明显影响.结论多个手指掌指关节平面的缺损采用游离双足第2趾及组织瓣再造的方法可以重建部分手功能，正确选择手术适应证．可以获得满意的效果。Objective To report the clinical efficacy in reconstruction of metacarpophalangeal joint plane defect of multiple fingers. Methods From January 2003 to January 20]0, using the free vascularized second toe and tissue grafts for treating multiple finger metacarpal joint plane defects in 23 patients, of which 1 to 5 the metacarpophalangeal joint defects in 1l cases, 2 to 5 metacarpophalangeal joint defects in 12 cases. 12 cases with vary degrees defects in palim, dorsal skin and soft tissue, the area ranged 3cm×5cm -15cm×12cm. A total of 23 patients with 32 finger reconstruction. Results All 32 fingers survived after operation, 1 case occured skin necrosis in dorsal skin graft donor site, skin grafting and wound healing after a second operation. After 5 to 25 months （mean 10 months） follow-up, the reconstructed fingers have recovered grasp, pinch and digital opposition functions, the feeling of those reconstructed flap recovered S2 - S3 ＋, basic self-care. No significant effect on the donor walking. Conclusion The method of reconstruction multiple finger metacarpophalangeal joint plane defects with free the second toe and tissue flap can reconstruct partial hand functions; correct choice of surgical indications could get good results.

关 键 词：指 损伤 移植 功能重建 

分 类 号：R[医药卫生]