改良第二跖趾关节移植修复木工机械致掌指关节背侧缺损  

Modified metatarsophalangeal joint composite transplant from the second toe for reconstruction of composite dorsal tissue defects of the metacarpophalangeal joint caused by machinery injury

作　　者：李卫[1] 刘金伟[1] 何藻鹏[1] 蔡厚洪 林绍仪 吴举[1] 李春雨[1] 梁观钦 

机构地区：[1]广东省创伤救治科研中心乐从临床基地佛山市顺德区乐从医院手足外科,佛山528315

出　　处：《中华手外科杂志》2013年第3期167-169,共3页Chinese Journal of Hand Surgery

基　　金：广东省医学科学技术研究基金项目（A2012674）

摘　　要：目的探讨一种新的改良第二跖趾关节移植修复木工机械致掌指关节背侧缺损的方法及临床疗效。方法2006年12月至2011年12月，针对木工机械致掌指关节损伤的特点，设计并改良第二跖趾关节复合组织瓣，经过重建，保留复合组织瓣背侧半，用于修复掌指关节冠状面背侧复合组织缺损共16例23个掌指关节。结果17个修复的掌指关节获得随访，时间6～24个月，X线片提示骨骼愈合。重建掌指关节均获得较好的功能恢复。按中华医学会手外科分会拇手指再造功能评定试用标准评定，优良率为94．12％。结论改良第二跖趾关节移植修复木工机械致掌指关节背侧缺损临床可行，能有效改善损伤掌指关节的功能。Objective To explore a new modified procedure to transfer composite tissue of the metatarsophalangeal joint of the second toe to repair dorsal defects of the metacarpophalangeal joint and to evaluate its clinical efficacy. Methods From December 2006 to December 2011, according to the characteristics of metacarpophalangeal joint injuries by woodworking machinery in our district, a modified second toe metatarsophalangeal joint composite flap was designed. The dorsal parts of the composite tissue transplant were reserved. They were transferred to repair composite dorsal tissue defects in the coronal plane of the metacarpophalangeal joints of the hand. Results This group included defects of 23 metaearpophalangeal joints in 16 cases. Seventeen joints successfully reconstructed using the new modified technique were follow-up from 6 to 24 months. These joints showed X-ray evidence of bone healing in all cases. Recovery of joint function was satisfactory. According to the Functional Evaluation Criteria for Reconstruction of Thumb and Fingers issued by Hand Surgery Society of Chinese Medical Association, the excellent and good rate was 94.12%. Conclusion It is feasible to reconstruct composite dorsal tissue defects in metacarpophalangeal joints of the hand by transplantation of modified second toe metatarsophalangeal joint composite flap. Effective improvement of functions of the injured metaearpophalangeal joint can be achieved.

关 键 词：掌指关节 跖趾关节 移植 冠状面 背侧 

分 类 号：R[医药卫生]