关键词：组织移植；指损伤；趾；显微外科手术
【摘要】 目的 探索重建拇指末节半侧缺损的理想术式——趾腓侧部分趾甲瓣移植。 方法 取对侧趾腓侧部分趾甲瓣重建拇指末节桡半侧缺损,同侧趾腓侧部分趾甲瓣重建拇指末节尺侧缺损。 吻合趾 - 指动静脉以重建血循环。 结果 临床应用3例均获成功。 术后随访3 ～ 6年,指甲对合、生长良好,外形满意;重建的末节半侧均有出汗,两点辨别觉为4 ～ 6 mm，患者均已恢复工作。 结论 采用吻合趾 - 指动静脉的趾腓侧部分趾甲瓣重建拇指末节半侧缺损,是一种比较理想的手术方法。
Reconstruction of half side defect of the distal segment of the thumb
CHENG Guoliang, YANG Zhi -xian, QU Zhiyong, et al. The Department of Hand Surgery and Microsurgery Center of CPLA, The 401st Hospital of CPLA, Qingdao 266071
【Abstract】 Objective To evaluate the outcome of the surgical procedure, transplantation of fibular wrap - around flap from the big toe, for reconstruction of half side defect of the distal segment of the thumb. Methods For the radial defect of the distal segment of the thumb,fibular wrap - around flap from the contralateral big toe was transplanted. The fibular wrap - around flap from the ipsolateral big toe was harvested for the ulna half defect. The digital arteries and nerves of the flap were anastomosed to their respective counterparts of the thumb.The procedure was applied in 3 cases. The postoperative follow - up was 3 to 6 years. Results The transplanted nail grew well and got union with the remaining thumb nail, with satisfactory appearance. The reconstructed part of the thumb had sweating function, with 2-PD of 4 to 6 mm. All the patients were capable of their original jobs after the operation. Conclusions It is an ideal procedure to reconstruct half side defect of doing the thumb by transplantation of fibular wrap - around flap from the big toe.
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