[足母]趾增宽术在缺损手指全形再造中的应用效果观察  

Observation on the application effect of great toe widening surgery in full-shaped reconstruction of defective fingers

作　　者：郝丽文[1] 王增涛[1] 荣凯 侯致典[1] 陈超[1] 仇申强 刘林峰 张迪 王云鹏 钟硕 Hao Liwen;Wang Zengtao;Rong Kai;Hou Zhidian;Chen Chao;Qiu Shenqiang;Liu Linfeng;Zhang Di;Wang Yunpeng;Zhong Shuo(Department of Hand and Foot Surgery,Shandong Provincial Hospital Affiliated to Shandong First Medical University,Jinan 250021,China;Department of Reconstruction Surgery,Shandong Public Health Clinical Center,Jinan 250021,China)

机构地区：[1]山东第一医科大学附属山东省立医院手足外科,济南250021 [2]山东省公共卫生临床中心修复重建外科,济南250021

出　　处：《中华损伤与修复杂志（电子版）》2023年第6期476-479,共4页Chinese Journal of Injury Repair and Wound Healing(Electronic Edition)

摘　　要：目的观察[足母]趾增宽术应用于缺损手指全形再造术后供受区外观、功能的远期效果。方法选择2020年9月至2023年5月山东第一医科大学附属山东省立医院手足外科一期行[足母]趾增宽术,二期从增宽的[足母]趾切取[足母]甲骨皮瓣游离移植行缺损手指再造术患者共12例(14指)。其中男5例(5指),女7例(9指)。二期手术前,供区[足母]趾行X线片检查,测量增宽[足母]趾的趾甲宽度和末节趾骨甲粗隆宽度。一期[足母]趾增宽术与二期手指全形再造术平均间隔11.4(7~17)个月。二期手指全形再造术后平均随访10.8(6~26)个月,观察再造手指成活情况及手指和[足母]趾的外观、功能。结果一期[足母]趾增宽术后,趾甲平均增宽1.4(0.9~1.8)cm,增宽比例平均为82.8%(52.9%~114.3%);末节趾骨甲粗隆平均增宽1.5(1.0~2.1)cm,增宽比例平均为131.9%(83.3%~190.9%)。二期手指全形再造术后,12例(14指)手指全部完全成活,均未发生血管危象。远期随访,再造的手指外观、功能近似健指,[足母]趾供区趾甲宽度接近正常,[足母]趾外观饱满,行走等功能无明显异常。结论[足母]趾增宽术用于缺损手指全形再造,在满足再造手指外观、功能近似正常手指的前提下,还可使[足母]趾的外观和功能不受影响。Objective To observe the long-term effects of great toe widening surgery on postoperative appearance and function of the donor and recipient areas in the full-shaped reconstruction of defective fingers.Methods From September 2020 to May 2023,a total of 12 patients(14 fingers),including 5 males(5 fingers)and 7 females(9 fingers)in Department of Hand and Foot Surgery,Shandong Provincial Hospital Affiliated to Shandong First Medical University were involved.The patients were performed great toe widening surgery in the first stage,and free lateral hallux osteo-onychocutaneous flaps from the widened toe for finger reconstruction in the second stage.Before the second stage surgery,X-ray examination of the donor site′s great toe was conducted to measure the width of the widened toe nail and the width of the distal phalanx nail tuberosity.The average interval between the first stage great toe widening surgery and the second stage finger reconstruction surgery was 11.4(7-17)months.The average follow-up period after the second stage finger reconstruction was 10.8(6-26)months.The survival of the reconstructed fingers,and the appearance and function of the fingers and great toes were observed.Results After the first stage great toe widening surgery,the average width of the toenails was increased by 1.4(0.9-1.8)cm,with an average widening ratio of 82.8%(52.9%-114.3%).The average widening of the distal phalanx nail tuberosity was 1.5(1.0-2.1)cm,with an average widening ratio of 131.9%(83.3%-190.9%).After the second stage finger reconstruction surgery,all reconstructed fingers survived completely,and did not experience vascular crisis.Long term follow-up showed that the appearance and function of the reconstructed fingers were similar to those of healthy fingers,and the width of the toenails in the donor area was close to normal.The appearance of the great toe was plump,and there were no significant abnormalities in walking and other functions.Conclusion The great toe widening surgery used for full-shaped finger reconstructio

关 键 词：手指缺损 [足母]趾增宽术 [足母]甲骨皮瓣 

分 类 号：R658.3[医药卫生—外科学]