第一二足趾组合移植拇指再造的临床应用  

Clinical experience of thumb reconstruction by combined transplantation of the first and second toe

作　　者：张珊珊[1] 崔晓林[1] 张博[1] 高峰[1] 梁久龙 ZHANG Shan-shan;CUI Xiao-lin;ZHANG Bo;GAO Feng;LIANG Jiu-long(Department of Burn and Plastic Surgery,Laoning Provincicil General Hospital of Armed Police,Shenyang 110034,China)

机构地区：[1]武警辽宁省总队医院烧伤整形科,辽宁沈阳110034 [2]北部战区总医院整形外科,辽宁沈阳110016

出　　处：《中国美容整形外科杂志》2020年第12期710-712,737,共4页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的探讨应用第一二足趾组合移植行拇指再造的临床效果。方法选取2016年6月至2018年6月收治的12例单纯拇指损伤患者作为研究对象。供区选择对侧足,于全身麻醉下行第一二足趾组合移植拇指再造术。所有患者均采用静态两点辨别觉方法评价重建拇指的感觉恢复。使用液压手测力计评估握力,与正常对侧手的握力比较。由两名未参与手术的外科医师对患者手术进行客观满意度评估。所有患者均被要求评估重建拇指的功能和外观的主观满意度。结果成功完成12例拇指重建。术后拇指平均两点辨别觉为(8.1±0.9)mm,供区平均两点辨别觉为(7.6±1.1)mm。与健侧手的握力比较百分率为(88.0±4.2)%。主客观评价所有患者对重建拇指和供区的外观、运动功能及感觉功能表示满意。结论根据拇指的损伤程度选择第一二足趾组合进行的拇指重建临床效果较好,值得推广。Objective To explore the clinical experience of thumb reconstruction by combined transplantation of the first and second toe.Methods From June 2016 to June 2018,12 patients with thumb injury alone were selected as the study subjects.The contralateral foot was selected as the donor site.The thumb reconstruction by combined transplantation of the first and second toe was performed under general anesthesia.The sensory recovery of reconstructed thumb in all patients was evaluated by static two-point discrimination method.The grip strength was evaluated by hydraulic hand dynamometer and compared with the normal contralateral hand.Patients’satisfaction was evaluated by 2 surgeons who did not participate in the operation.The subjective satisfaction of the function and appearance of reconstructed thumbs was evaluated by all patients.Results Twelve cases of thumb reconstruction were successfully completed.The average static two-point discrimination of the reconstructed thumb was(8.1±0.9)mm and the donor site was(7.6±1.1)mm.Compared with the grip strength of the healthy hand,the percentage is(88.0±4.2)%.The subjective and objective evaluation of the appearance,motor function and sensation of the reconstructed thumb and donor site is satisfactory.Conclusion According to the degree of thumb injury,the clinical efficacy of thumb reconstruction by combined transplantation of the first and second toe is good.It should be considerable to popularization.

关 键 词：拇指再造 第一二足趾组合移植 术后评价 

分 类 号：R658.3[医药卫生—外科学]