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1、中华医学杂志2005年10月12日第85卷第38期NatlMedJChina,October12,2005,Vol85,No138·2667··论著·拇手指部分缺损的修饰性修复与重建程国良方光荣侯书健袁光海王振军张云飞丁小珩汤海萍杨志贤【摘要】目的评估对拇、手指末节部分缺损,选用相应部分足趾组织移植修饰性修复与重建的临床效果,提出修饰性修复与重建的新理念。方法对77例80指拇、手指末节半侧、背侧、指腹及手指部分复合组织缺损选用足趾末节半侧甲瓣,背侧甲瓣,趾腹皮瓣及足趾相应部分复合组织移植,采用吻合趾2指动静脉重建血液循环
2、,施行修饰性修复与重建。结果成活75例78指,成活率为9715%,术后经半年至12年随访,保持了手指原来长度与外形,重建了指甲,使指腹饱满,具有罗纹,出汗,两点分瓣觉为4～6mm,获得较完美的外形与功能。结论对拇、手指末节部分复合组织缺损,选用相应部分足趾半侧甲瓣、背侧甲瓣、趾腹皮瓣及复合组织移植的修饰性修复与重建,可达到精细修复效果和修饰性修复与重建的目的。【关键词】拇指;指损伤;移植,自体;吻合术,外科;修复外科手术Decorativerepairandreconstructionofsubtotaldefectof
3、thumbandfingerwithtrimmedtoeflaptransferCHENGGuo2liang,FANGGuang2rong,HOUShu2jian,YUANGuang2hai,WANGZhen2jun,ZHANGYun2fei,DINGXiao2heng,TANGhai2ping,YANGZhi2xian.DepartmentofHandSurgery,HospitalNo401ofthePeople'sLiberationArmy,Qingdao266071,China【Abstract】Objecti
4、veTosummarizethenewprocedurefordecorativerepairandreconstructionofsubtotaldefectofthumbandfingerwithtrimmedtoeflaptransfer.MethodsSeventy2sevenpatientswith88thumband/orfingersubtotaldefectintheformoflateralhalf,dorsalhalf,prvolarhalfcompositetissuedefectwererecon
5、structedwiththelateralnail2skinflap,dorsalnail2skinflap,orpulpflaptakenfromthecorrespondingpartsoftoes.Bloodcirculationwasre2establishedbyanatomizethedigitalarteriesofthetoesandfingers.Follow2upwasconductedfor6monthsto12years.ResultSeventy2eightin77casessurvivedw
6、ithanoverallsurvivalrateof97.5%.Thesurvivingfingersallpreservedusuallength,fine2lookingappearance,withnailandfullpulp,andnormalfunctions,includingsweatingfunctionandatwo2point2discriminationof4～6mm.ConclusionBetterthananytraditionaltoe2to2handtransfer,theprocedur
7、eofrepairandreconstructionofsubtotaldefectofthumbandfingerwithtrimmedtoeflaptransfernotonlyrestorethefunctionofthewoundedthumband/orfinger,butalsohelptheobjectiveofdecoration.【Keywords】Thumb;Fingerinjuries;Transplantation,autologous;Anastomosis,surgical;Reconstru
8、ctionsurgicalprocedures因外伤造成手指末节侧方、背侧、掌侧或指体某似组织修复的完美外形,保持了原来长度,重建了指一部分复合组织缺损,若采用简单的截指及残端修甲和罗纹,恢复了良好的感觉与功能,获得了理想的整缝合的外科治疗,必将造成手指部分缺损而影响专科修复。外形与功能;若采用传统的邻指皮瓣,交臂皮
