游离趾甲皮瓣再造拇指的远期疗效

THUMB RECONSTRUCTION WITH BIG NAIL SKIN FLAP: A LONG PERIOD FOLLOW UP

目的：评价游离趾趾甲皮辨移植再造拇指的远期疗效。方法：对１９８７年１１月～１９９５年４月间施行该手术的２８例作远期随访，检测再造拇指的外形、长度、出汗情况、感觉及运动功能和术后对行走功能的影响等６个项目。结果：对获得完整资料的２１例作了综合分析，其中再造拇指的综合功能为优１８例；疗效欠佳３例。其原因是未吻合趾－指神经、感觉功能恢复不良及掌指关节融合。结论：吻合血管游离趾趾甲皮瓣移植再造拇指是治疗拇指全指撕脱伤及Ⅲ－Ⅳ度拇指缺损疗程短、效果较好的手术方法。

Objective: A long period curative effect of thumb reconstruction with big nail skin flap was appraised Methods: The author made a long period follow up the 28 patients who had accepted thumb reconstruction from Nov, 1987 to April, 1995 with big nail skin flap, and summerized the results of 21 patients whose data were completely acquired, according to the shapes, length, sweating, sensory and motor functions, and influence on the function of walk after operation of the reconstructed thumb Results: Eighteen cases were satisfactory, and because of non anastomosing finger toe nerve and performing first metacarpophalangeal arthrodes is on the reconstructed thumb The other three comparatively poor Conclusion: To reconstruct defected thumb within Ⅲ～Ⅳ degree, transplantation with big nail skin flap is a short period and high effect method