部分足趾游离移植修饰性再造指尖部缺损  

Reconstruction of fingertip defect modified by partial toe free transplantation

作　　者：杨小文 江吉勇 曾凡雨 陈永健 喻田 YANG Xiaowen;JIANG Jiyong;ZENG Fanyu(Department of Hand and Foot Microsurgery,Shenzhen Overseas Chinese Hospital Affiliated to Jinan University,Shenzhen,Guangdong,518111,China)

机构地区：[1]暨南大学附属深圳华侨医院手足显微外科,广东深圳518111 [2]广州和平骨科医院创伤显微五区,广东广州510315

出　　处：《实用手外科杂志》2023年第2期190-192,共3页Journal of Practical Hand Surgery

摘　　要：目的探讨应用部分足趾游离移植修饰性再造拇手指指尖缺损的方法和临床疗效。方法2016年1月-2021年10月,采用趾及第2、3足趾末节组织游离移植修饰性再造拇手指指尖部缺损20例。供区采用趾8例,第2足趾末节10例,第3足趾末节2例,修饰性再造拇指指尖缺损8例,示指指尖缺损6例,中指指尖缺损6例。择期手术15例,急诊手术5例。所有病例术后均获规律随访。随访截至时间2022年10月。结果术后20例再造指尖全部成活,其中1例右中指指尖再造术后1 d出现血管危象,经急诊手术探查后血管危象解除,再造指成活。术后随访6~24个月,平均11.8个月,再造拇手指指尖外形同健侧手指极为接近,手指功能优良,再造指尖均恢复保护性感觉。末次随访根据中华医学会手外科学会上肢部分功能评定试用标准评定功能:优18例,良2例。结论应用部分足趾游离移植修饰性再造拇手指指尖部缺损,再造指外形美观,功能优良,供足创伤小,值得临床推广。Objective To investigate the method and clinical effect of partial toe free transplantation for reconstruction of fingertip defect of thumb and finger.Methods From January 2016 to October 2021,a total of 20 cases of defect at the tip of the hallux finger were reconstructed by free transplantation using hallux toe and part of the distal segments of the second and third toes.In the donor area,8 patients had great toe,10 patients had the second toe,and 2 patients had the third toe.There were 8 cases of thumb fingertip defect,6 cases of index finger defect and 6 cases of middle finger defect.There were 15 cases of elective operation and 5 cases of emergency.All patients in this group were followed up regularly.Follow-up up to October 2022.Results All the 20 patients survived.one case of right middle finger fingertip reconstruction indicated vascular crisis 1 day after surgery.After emergency surgical exploration,the vascular crisis was relieved and the reconstruction indicated survival.The postoperative follow-up lasted from 6 to 24 months,with an average of 11.8 months.The shape of the fingertip of the reconstructed thumb finger was very close to that of the healthy finger,and the fingertip function was good.According to the trial standard of upper limb function evaluation of the Chinese Society of Hand Surgery of the Chinese Medical Association,the last follow-up function evaluation of 20 cases in this group was excellent in 18 cases and good in 2cases.Conclusion Partial free toe transplantation can be used to reconstruct the defect of thumb and fingertip.The reconstructed finger is beautiful in appearance,good in function,and less traumatic in foot supply,which is worthy of clinical promotion.

关 键 词：手外伤 指尖缺损 足趾移植 修饰性再造 显微外科 

分 类 号：R658.2[医药卫生—外科学]