趾动脉皮瓣在足部多趾并趾畸形修复中的应用  

Application of metatarsal artery flap for repairing polysyndactyly and syndactyly of toes

作　　者：汪洋[1,2] 张宁[1,2] 胡勇[1,2] 连晓杰[1,2] 程瑞林[1,2] 徐文鹏 

机构地区：[1]山东大学第二医院手足外科,济南250033 [2]山东大学足踝外科研究中心

出　　处：《中华小儿外科杂志》2016年第3期186-189,共4页Chinese Journal of Pediatric Surgery

基　　金：山东省自然科学基金（ZR2014HM058）;山东大学第二医院种子基金（S2015010010）

摘　　要：目的设计以同趾或邻趾的趾动脉为蒂的岛状皮瓣来修复分趾后趾蹼区的皮肤缺损。方法2010年1月至2013年1月间共收治并趾多趾畸形49例，28例获得随访。其中，男19例，女9例；年龄13-44个月，平均27．1个月。其中[足母]多趾畸形7例；并趾畸形21例，包括：第1、2趾并趾畸形5例，第2、3趾并趾畸形3例，第3、4趾并趾畸形4例，第4、5趾并趾畸形9例。所有患儿分趾后均采用趾动脉皮瓣修复趾蹼部皮肤缺损。供区趾体损伤面积较小，可直接缝合，无需植皮。结果术后所有并趾畸形均得到了矫正，趾间获得很深的趾蹼和自然张开的弧度。出院后28例获得随访，平均随访时间8个月。随访期间发现皮瓣质地柔软，外形满意，无色差，伤指无疼痛，两点分辨率在4～10mm.结论使用趾动脉皮瓣可完全修复并趾分趾后的软组织缺损而无需植皮，且供区可直接缝合，同时可有效地改善趾蹼外形，是修复足趾并趾分趾畸形的一种安全、有效的新方法。Objective To design a pedicled island flap with metatarsal artery for repairing skin defect after separating polysyndactyly and syndaetyly. Methods Among 49 cases, 28 of them were followed up from January 2010 to January 2013. There were polysyndactyly （n = 7） and syndactyly （n = 21）. And the latter involved first ＆ second toes （n = 5）,second ＆ third toes （n = 3）, third ＆ fourth toes （n = 4） and fourth ＆ fifth toes （n = 9）. Pedicled island flap with metatarsal artery was used for repairing skin defect after separating polysyndactyly and syndactyly without skin grafts. Results All cases were corrected successfully with deep toe-webs and natural expansion between toes During a median follow up period of 8 months,excellent appearance and texture appeared without local pain. The color of flap was similar to that of adjacent skin. And static two-point discrimination was 4 to 10 mm. Condnsions Pedicled island flap with metatarsal artery may repair left skin defect fully after separating polysyndactyly and syndactyly without skin grafting. And donor site may be readily sutured. Thus metatarsal artery flap transplantation is reliable, safe and efficient for repairing polysyndactyly and syndactyly of toes.

关 键 词：多趾 并趾 先天畸形 皮瓣移植术 

分 类 号：R726.5[医药卫生—儿科]