拇甲皮瓣再造指尖  

Reconstruction of thumb and f＇mgertip defects with wrap-around flap from the big toe

作　　者：李文君 苏波 张玲玲 孙长胜 钱英俊 王婷婷 

机构地区：[1]上海中冶医院富锦路分院手外科,201900

出　　处：《中华手外科杂志》2016年第3期202-204,共3页Chinese Journal of Hand Surgery

摘　　要：目的探讨利用拇趾腓侧趾底动脉分支为营养血管的复合组织瓣再造指尖的方法及疗效。方法自2013年1月至2015年6月，采用由拇趾腓侧趾底动脉分支为营养血管的复合组织瓣游离移植修复6例拇指、9例手指指尖毁损；拇趾供叹采用拇趾胫侧瓣转移覆盖修复。结果术后再造指尖全部存活。经过3～14个月随访，功能良好，15例趾甲全部生长，13例趾甲平整、外形满意，2例趾甲不平整，其中1例缝合口瘢痕增生挛缩明显，拇趾供区皮瓣修复处无磨损破溃发生。结论拇趾腓侧趾底动脉分支为营养血管的复合组织瓣再造指尖是一种损伤较小且可靠的治疗方法。Objective To evaluate the method and clinical outcomes of big toe composite tissue flap transplantation with fibular branch of the proper plantar artery as feeding vessel for coverage of thumb and finger tip dcfects. Methods From January 2013 to June 2015, 6 cases with thumb tip defects and 9 cases with fingertip defects were repaired by the big toe composite tissue flap transplantation with anastomosing fibular branch of the proper plantar artery to the feeding vessel. Donor site of the big toe was covered by a tibial side flap. Results All 15 wrap-around flaps from the big toe survived. Postoperative follow-up ranged from 3 to 14 months. All the reconstructed digits had favorable functions and nail growth. The reconstructed nail was smooth in 13 cases and uneven in 2 cases. Scar hyperplasia and contracture was seen in 1 case. There is no abrasion or ulceration of the flaps that covered the donor site. Conclusion Big toe composite tissue flap transplantation with fibular branch of the proper plantar artery as feeding vessel is a less invasive and reliable method for coverage of thumb and fingertip defects.

关 键 词：外科皮瓣 指损伤 趾底动脉 

分 类 号：R658.2[医药卫生—外科学]