基于数字化技术施行游离部分第2跖趾关节组织瓣精准修复手部小关节缺损  

Precise repair of small joint defect of hand with free second metatarsophalangeal joint tissue flap based on digital technology

作　　者：刘东波 何藻鹏 李卫 廖贤万 韦春荣 郑玉东 曾迪藩 周湘桂 LIU Dongbo;HE Zaopeng;LI Wei;LIAO Xianwan;WEI Chunrong;ZHENG Yudong;ZENG Difan;ZHOU Xianggui(Department of Hand and Foot Surgery,Shunde Hospital Affiliated to Guangzhou Medical University(Foshan Shunde Lecong Hospital),Foshan,Guangdong Province 528315,China)

机构地区：[1]广州医科大学附属顺德医院(佛山市顺德区乐从医院)手足外科,广东佛山528315

出　　处：《中华显微外科杂志》2023年第1期64-69,共6页Chinese Journal of Microsurgery

基　　金：佛山市"十四五"医学培育专科项目(FSPY145052);佛山市深入推进创新驱动助力工程项目(2021042)。

摘　　要：目的探讨数字化3D打印技术辅助下精准切取部分第2跖趾关节组织瓣游离移植修复手部指骨间关节缺损的临床效果。方法 2016年12月至2020年12月,广州医科大学附属顺德医院(佛山市顺德区乐从医院)手足外科收治7例近侧手指指骨间关节部分关节缺损患者,术前采集手、足骨骼三维数据,利用3D打印模型体外模拟手术,术中应用以第1跖背动脉-第2趾背动脉为蒂,在导航模板辅助下切取所需大小的第2跖趾关节复合组织瓣,移植修复手部小关节缺损。本组7例均采用门诊和电话随访。结果本组7例病例移植组织瓣全部成活;术后随访3~24(平均9.5)个月,修复的指骨间关节活动度为(56±6)°;按中华医学会手外科学会拇、手指再造功能评定标准进行评定:优2例、良4例、差1例。结论 3D打印技术辅助下游离第2跖趾关节组织瓣移植修复手部小关节缺损,能精准切取组织瓣,疗效可靠,值得推广。Objective To explore the clinical effect of repairing interphalangeal joint defect of hand with free transfer of part of the 2nd metatarsophalangeal joint tissue flap precisely cut with the aid of digital 3D printing technology.Methods From December 2016 to December 2020,7 patients with partial joint defects of proximal interphalangeal joints of fingers were treated in Department of Hand and Foot Surgery,Shunde Hospital Affiliated to Guangzhou Medical University(Foshan Shunde Lecong Hospital).Before surgery,three-dimensional data of hand and foot bones were collected,and the 3D printing model was used to simulate the operation in vitro.During the operation,the first dorsal metatarsal artery-the 2nd dorsal metatarsal artery was used as the pedicle,and the 2nd metatarsophalangeal joint composite tissue flap with a required size was harvested with the assistance of the navigation template to tranfer and repair the small joint defects of hand.All 7 cases entered follow-up at outpatient and telephone.Results All 7 cases survived.Postoperative follow-up was 3-24(mean 9.5)months,Range of motion of the repaired interphalangeal joint was(56±6)°;According to the Evaluation Standard of Thumb and Finger Reconstruction Function of the Society of Hand Surgery of the Chinese Medical Association,2 cases were excellent,4 cases were good,and 1 case was poor.Conclusion Transfer of the free 2nd metatarsophalangeal joint tissue flap assisted by 3D printing technology in repair of the small joint defect of the hand can accurately harvest the tissue flap,which is clinically reliable.

关 键 词：近侧指骨间关节缺损 第2跖趾关节 3D打印 移植 数字化技术 

分 类 号：R658.2[医药卫生—外科学]