拇手指再造术的临床体会

Clinical experience of finger and thumb reconstruction

目的探讨足趾组织游离移植拇手指再造手术的临床疗效。方法自2000年9月-2007年4月,针对各种类型的拇手指缺损或软组织缺损,采用不同形式的足趾组织游离移植进行拇手指再造手术共42例46指。结果再造手指坏死1例,其余41例45指全部成活。随访时间3个月～2年,按中华医学会手外科分会上肢部分功能评定试用标准进行评定[1]:优15指,良20指,可8指,差2指。结论适宜的手术时机、娴熟的显微外科技术、血管变异与危象的正确处理和积极的康复训练,是足趾组织游离移植拇手指再造手术成功的关键。

Objective To explore the clinical effect of finger or thumb reconstruction with free toe. Methods 42 patients with 46 finger defects received different types of digital reconstructive operation with free toe tissue from September of 2000 to April of 2007.Results 45/46 fingers survive. According to the criterion of the Society of Hand Surgery CMA：Good rate was 77.7%. Conclusion Proper operation time ,skilled microsurgical technique, treatment of vascular variation or crisis and active rehabilitation training were the keys to the finger reconstruction.