[母]甲瓣联合第二足趾复合组织移植亚急诊再造Ⅲ～Ⅳ度缺损的拇指  

Subemergency reconstruction of grade Ⅲ and Ⅳ thumb defect by great toe wrap-around flap combined with the tissue flap of second toe

作　　者：曹学新 陈金峰 常荣刚 张顺强 

机构地区：[1]德州手足外科医院,山东省德州市253000

出　　处：《中华显微外科杂志》2015年第3期254-257,共4页Chinese Journal of Microsurgery

摘　　要：目的 探讨[母]甲瓣联合第2足趾复合组织移植亚急诊再造Ⅲ-Ⅳ度缺损的拇指的手术方法及临床疗效. 方法 自2011年7月至2014年3月,我院对12例拇指Ⅲ-Ⅳ度缺损的患者采取吻合血管蒂的（足母）甲瓣包裹第2足趾骨、关节、肌腱的复合组织移植亚急诊再造拇指,供区咬除第2跖骨头,修复跖骨头间横韧带,将第2趾甲瓣移位覆盖[母]趾供区创面.结果 12例再造拇指全部存活.术后随访6- 24个月,再造拇指功能满意,外形与健侧拇指接近,感觉恢复良好,指腹两点分辨觉为0.6-0.8cm.按中华医学会手外科学会上肢部分功能评定试用标准评定：优9例,良3例.供足恢复良好,术后1个月即能下地负重行走,远期随访无明显疼痛及跛行,无糜烂破溃. 结论 [母]甲瓣联合第2足趾复合组织移植亚急诊再造Ⅲ-Ⅳ度缺损的拇指,既能恢复良好的功能和感觉,又具有美观的外形.Objective To explore the surgical technique and clinical effect of combined great toe wraparound flap and second toe tissue flap transfer for subemergency reconstruction of grade Ⅲ and Ⅳ thumb defect.Methods From July,2011 to March,2014,12 patients of grade Ⅲ and Ⅳ thumb defect were treated by transfering combined great toe wrap-around flap and second toe tissue flap transfer.The second toe tissue flap was carried out to cover donor site defect of the big toe.Results All the 12 transplants survied and were followed up for 6 to 24 months.The reconstructed thumbs had near nomal appearace and good fuction,2-point discrimination ranged from 0.6 cm to 0.8 cm.According to the trial standard of upper limb part of functional assessment of the Hand Surgery Branch of Chinese Medical Association,among the 12 eases,there were excellent in 9,good in 3.Impact on the donor foot was minor with limited complications.The patients were able to weight-bearing walking after one months of operation.For long-term follow-up,no case had successive ulces,obvious pain and claudication.Conclusion The reconstructed thumbs by great toe wrap-around flap combined with the tissue flap of second toe had near nomal appearace and good fuction.

关 键 词：拇指再造 [母]甲瓣 第2足趾 显微外科技术 

分 类 号：R658.2[医药卫生—外科学]