游离足趾移植急诊拇手指再造106例

Thumb and finger reconstruction of 106 cases with free toe transplantation in emergency

目的总结游离足趾移植急诊拇手指再造的临床经验,进一步探讨游离足趾移植急诊拇手指再造的可行性。方法1997年1月～2005年2月收治外伤性拇手指缺损患者106例,清创后,采用!趾移植急诊再造拇指8例,第二足趾移植再造拇指69例、再造中指7例、再造食指4例、再造环指3例、再造手1例,双侧第二足趾移植同时再造拇食指3例、再造食中指7例、再造中环指3例、再造手1例。结果再造拇手指106例119指成活118指,无一例感染,经3～66个月随访,所有再造拇手指血运丰富,感觉恢复良好,对指和对掌灵活。结论对于外伤性拇手指缺损,经过彻底清创,科学设计,采用游离足趾移植急诊再造,可以获得满意的再造效果。

Objective To sum up the clinical experience of thumb and finger reconstruction with free toe transplantation in emergecy and further discuss its feasibility. Methods We reconstructed 106 cases suffered traumatic defects of thumb and /or finger （n=119） in emergency with free second-toe transplantation after through debridment. Of 119 thumbs and fingers, 8 reconstructed with first-toe, and 69 thumbs, 7 long fingers, 4 index fingers, 3 ring hand with second-toe; 3 thumbs and index fingers, 7 index fingers and long fingers, first-toe and thumbs were fingers and 1 3 long fingers and ring fingers,and one hand with biolateral second-toes. Results All cases survived except one failed and there were no other complications, after 3-66 months＇follow-up, all the cases showed good vascularization, sensation, motion and opposition. Conclusion The traumatic defects of thumb and finger can be reconstructed with toe transplantation in emergecy, and it can get ideal clinical effects if through debridment and scientific design were put into use.