游离双[⻊母]趾腓侧甲皮瓣移植拼接再造拇指一例  

Thumb reconstruction with free spliced bilateral fibular hallux nail flap:A case report

作　　者：李苗钟 刘林海[1] 俞淼 周晓玲[1] 李学渊[1] LI Miaozhong;LIU Linhai;YU Miao;ZHOU Xiaoling;LI Xueyuan(Department of Hand Surgery,Ningbo No.6 Hospital,Ningbo,Zhejiang Province 315040,China)

机构地区：[1]宁波市第六医院手外科,浙江宁波315040

出　　处：《中华显微外科杂志》2022年第6期688-691,共4页Chinese Journal of Microsurgery

摘　　要：2021年5月,宁波市第六医院手外科收治1例左拇指末节脱套性毁损性离断患者,采用游离双[⻊母]趾腓侧甲皮瓣移植拼接再造拇指。术中将[⻊母]趾腓侧[⻊母]趾底动脉与受区拇指掌侧固有动脉吻合,[⻊母]趾腓侧[⻊母]趾底神经与受区拇指掌侧固有神经缝接,同时吻合双[⻊母]趾腓侧甲皮瓣之间的[⻊母]趾底远端动脉弓,双足[⻊母]趾供区采用V-Y推进皮瓣修复。术后3个月随访,左拇指移植甲皮瓣成活良好,左拇指指甲生长良好,动态TPD为7 mm,按中华医学会手外科学会拇、手指再造功能评定标准评价,结果为优(14分)。足部供区推进皮瓣成活良好,双足行走、跑、跳功能均未受影响,按Maryland足功能评分标准,结果为优(98分)。A patient who suffered with degloving and destructive servered distal segment of the left thumb was referred to the Department of Hand Surgery,Ningbo No.6 Hospital in May 2021.The thumb was reconstructed by transfer and splicing of a free bilateral fibular hallux nail flap.Metatarsal artery of the metatarsal fibular side of the flap was anastomosed to the proper palmar digital artery at the recipient site.The nerve meridian were anastomosed to the proper palmar digital nerve of thumb,and the distal arterial arch of the metatarsal base between the flaps was anastomosed at the same time.A V-Y advancement flap was employed to repair the donor site.After 3 months,the transferred flaps survived well,the left thumb nail grew well,and the dynamic TPD was at 7 mm.According to the Evaluation Standard of Thumb and Finger Reconstruction Function of the Society of Hand Surgery of the Chinese Medical Association,it was evaluated as excellent(14 points).The advancement flap in the donor site survived well,and the walking,running and jumping of both feet were not affected.According to Maryland's foot function scoring standard,it was evaluated as excellent(98 points).

关 键 词：[⻊母]趾腓侧甲皮瓣 拇指再造 组织移植 吻合 

分 类 号：R658.2[医药卫生—外科学]