弃指游离指甲瓣移植在指端缺损修复中的临床应用

Clinical application of rejection finger nail flap free grafting for repairing of finger tip defect

目的探讨弃指指甲瓣在指端缺损修复中的应用效果。方法对32例43指(示指15指,中指13指,环指9指,小指6指)指端缺损采用指根神经阻滞麻醉,残端短缩清创,保留骨膜完整,将弃指的指甲瓣游离移植于指端,并采用弹性加压方法缝合加压。结果2例失访,30例(39指)得到随访,时间6～32个月,1指因感染失败而行皮瓣转移覆盖创面,余移植的指甲瓣全部成活。采用吕桂欣等方法进行疗效评定:优24例32指,占82%;良3例4指,占10%;差3例3指,占8%。结论采用弃指游离指甲瓣移植修复指端缺损操作简单,疗效满意。

Objective To research the application of repairing finger tip defect with the rejection finger nail free grafting.Methods 43 fingers with tip defect in 32 patients（15 index fingers,13 middle fingers,9 ring fingers,6 little fingers） were repaired by rejection finger nail flap free grafting.Finger root nerve blocking anesthesia was used.The rejection finger nail flap was free grafted to the finger tip defect and was pressurized with flexible pressure after debriding,decurtating the finger bone tip and keeping the integrity of periosteum.Results In this study,30 patients were followed up from 6 months to 32 months with an average of 18 months.There was 1 graft necrosis for infection,the other grafts were survived well.Excellent rates were 82% in 24 patients with 32 fingers;good rates were 10% in 3 patients with 4 fingers;poor rate was 8% in 3 patients with 3 fingers according to criteria by Lv Gui-xin.Conclusions Rejection finger nail flap free grafting to repair finger tip defect is simple to operate,the effect is satisfactory.