吻合血管的趾甲移植修复拇、手指指甲缺损  

Nail transplantation with blood supply for reconstruction of thumb or finger nail defect

作　　者：李秀平[1] 巨积辉[1] 刘新益[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215000

出　　处：《中国临床解剖学杂志》2013年第2期210-213,共4页Chinese Journal of Clinical Anatomy

摘　　要：目的总结吻合血管的趾甲移植修复拇、手指指甲缺损的临床效果。方法2003年2月～2011年2月，采用吻合血管的跚L趾甲移植修复拇指指甲缺损23例，采用吻合血管的第2趾趾甲移植修复2-4指指甲缺损40例。足部供区采用植皮或邻近皮瓣转移修复术。结果术后移植的23例躅趾趾甲、40例第2趾趾甲均成活。63例患者获随访5～30个月，平均13个月。随访患者修复后的手指外形满意，指甲生长良好，可以协助指腹完成抓、掐、捡针等动作。拇指指间关节屈曲达50°-90°，平均为65°。2-4指远指间关节屈曲达30°～70°，平均为50°。48例供足植皮者，2例在足背远端出现线状瘢痕挛缩，再次手术给予瘢痕切除改形后挛缩解除，余植皮区皮肤松软，质地可。结论应用吻合血管的蹰趾趾甲、第2趾趾甲移植修复拇、手指指甲缺损，可以很好地恢复指端的外形。Objective To summarize the clinical effects of nail transplantation with blood supply for reconstruction of thumb or finger nail defect. Methods From February, 2003 to February, 2011, we carried out 23 cases of toenail transplantation with blood supply to reconstruct thumb nail defect and 40 cases of toenail transplantation from the second digit of the foot with blood supply to repair nail defect of the second to the fourth finger. And skin grafting or the pedicled local flap was carried out at the donor site of the foot. Results The wound healing of the patients were all primary, and all 23 transplanted thumb nails and 40 transplanted nails from the second digit of foot were all successful. We followed up 63 patients for 5 - 30 months and the average of follow-up time was 13 months. The patients we followed up were satisfied with the appearance of their reconstructed fingers. The nails grew well with good touch sensation, which could assist the finger pulp to do some actions such as grasping, pinching, or picking up a needle. The flexion of interphalangeal joint of the patients with repaired thumbs could reach 500-90°, with an average of 65°. And the distal interphalangeal joint flexion of the patients with repaired 2-4 fingers reached 300-70° with an average of 50°. Two of the 48 donors for skin grafting had linear cicatricial contracture in feet. The contracture was relieved after a second surgery for cicatricle resection, and the texture of other skin grafdng area was good with loose and soft skin. Conclusion Nail transplantation with blood supply from from the thumb and the second digit of the foot can can notably repair the appearance of the fingers and also rebuild the functions of nails.

关 键 词：指甲 趾甲 显微外科 

分 类 号：R658.3[医药卫生—外科学]