吻合血管蒂的[母]甲皮瓣复合组织游离移植再造拇指的效果观察  

Effect observation of vascularized toe nail flap combined with free tissue grafting for thumb reconstruction

作　　者：邹建福 余志强 ZOU Jian-fu;YU Zhi-qiang(Department of Trauma and Orthopedics,Jianghua Hospital,Yangjiang 529500,China)

机构地区：[1]广东阳江江华医院创伤骨科,529500

出　　处：《中国实用医药》2023年第7期58-61,共4页China Practical Medicine

摘　　要：目的分析吻合血管蒂的[母]甲皮瓣复合组织游离移植再造拇指的效果。方法回顾性分析15例(15指)拇指缺损患者的临床资料,均通过吻合血管蒂的[母]甲皮瓣复合组织游离移植再造拇指。统计再造拇指的存活率、创面愈合时间、术后并发症发生情况,比较术前术后手指关节活动度、日常生活能力评分、满意度评分,所有患者术后均接受随访,评估其手功能。结果15例(15指)患者的再造拇指全部存活,存活率为100.00%(15/15)。创面愈合时间为21~28 d,平均创面愈合时间为(24.42±2.40)d。术后所有患者均未出现局部溃疡或者坏死等严重并发症,仅1例出现轻度感染,发生率为6.67%(1/15),经对症处理后恢复。术后,患者的手指关节活动度(88.65±5.32)°、日常生活能力评分(84.86±11.70)分、满意度评分(71.80±4.85)分均高于术前的(21.60±4.28)°、(59.84±10.25)分、(41.76±5.28)分,差异具有统计学意义(P<0.05)。所有患者随访6~20个月,平均随访(12.35±2.14)个月,随访结果显示,手功能优9例,良5例,中1例,差0例,优良率为93.33%(14/15)。结论吻合血管蒂的[母]甲皮瓣复合组织游离移植再造拇指效果理想,再造拇指的存活率较高,且并发症较少,能提高患者手指关节活动度、日常生活能力和对手外观的满意度,术后手功能恢复良好,值得采用。Objective To analyze the effect of vascularized toe nail flap combined with free tissue grafting for thumb reconstruction.Methods The clinical data of 15 patients(15 fingers)with thumb defects were retrospectively analyzed,all of whom had their thumb reconstructed by vascularized toe nail flap combined with free tissue grafting.The survival rate,wound healing time,and postoperative complications of the reconstructed thumb were counted,and the preoperative and postoperative finger-joint range of motion,activities of daily living scores,and satisfaction scores were compared,and all patients were followed up after surgery to assess their hand function.Results All of the reconstructed thumb in 15 patients(15 toes)survived,with a survival rate of 100.00%(15/15).The wound healing time ranged from 21 to 28 d,and the mean wound healing time was(24.42±2.40)d.All patients did not develop serious complications such as local ulceration or necrosis postoperatively,and only 1 case developed a mild infection with an incidence of 6.67%(1/15),which recovered after symptomatic treatment.Postoperatively,the finger-joint range of motion(88.65±5.32)°,activities of daily living score(84.86±11.70)points,and satisfaction score(71.80±4.85)points of patients were higher than those of(21.60±4.28)°,(59.84±10.25),and(41.76±5.28)points preoperatively,and the differences were statistically significant(P<0.05).All patients were followed up from 6 to 20 months,with a mean follow-up of(12.35±2.14)months.The followup results showed that hand function was excellent in 9 cases,good in 5 cases,moderate in 1 case,and poor in 0 case,with an excellent rate of 93.33%(14/15).Conclusion The effect of vascularized toe nail flap combined with free tissue grafting is ideal for thumb reconstruction,with high survival rate of the reconstructed thumb,less complications,and good recovery of hand function.It can improve the finger-joint range of motion,the activities of daily living and the satisfaction with the hand appearance of the patients.It is wort

关 键 词：组织移植 外科皮瓣 拇指再造 存活率 

分 类 号：R658.2[医药卫生—外科学]