游离足甲瓣移植术后足底应力变化的观察

The vola stress change of patients after operation of wrop around flap for thumb reconstruction

目的:通过分析甲瓣手术后患者的足底应力分布变化,了解传统的甲瓣手术方法对足底应力分布的影响。方法:自1996年至2004年行游离足甲瓣术后患者23例,男16例,女7例;年龄17～42岁,平均23.7岁。进行大体足印、足底应力静态测试、足底应力动态测试。手术至测试时间1.6～6年,平均3.8年。对测试结果进行分析。结果:无论静态站立还是动态行走,甲瓣患者术后供足足底应力分布较健足有明显区别,主要表现在足跟及第4、5足趾跖骨头下负重较健足无显著性差异,但前足变化明显,第1跖骨头下负重明显减轻,而第2、3跖骨头处压力分布增大,相较健足有显著性差异。结论:修复拇指缺损的游离足甲瓣法具有外形接近于正常拇指,美观等优点,但术后对足底应力分布有一定影响。

Objective：To analyse the vola stress change after operation of wrop around flap for thumb reconstruction,to know the influence of vola pressure change after operation of wrop-around flap. Methods：From 1996 to 2004,23 patients after the operation of wrop around flap for thumb reconstruction were measured the entire footprint,the vola stress of sigle foot and double feet on static state and walking status. There were 16 males and 7 females,with a mean age of 23.7 years （17 to 42 years）. The time from operation to measuring was 1.6 to 6 years （meana 3.8 years）. The results of measuring were analyzed. Results：Whether static footprint analysis or dynamic mechanical analysis,the plantar pressure distribution of donated foot were obviously different with those of the opposite site. The weight bearing of heel and the fourth and fifth metatarsal heads were nearly consistent with normal foot. But the former feet were obviously different. The weight bearing of the first metatarsal head was obviously lower than normal foot. And the weight bearing of the second and third metatarsal heads were obviously higher than normal foot. Conclusion：The operation of wrop around flap for thumb reconstruction has advantage of the cosmesis and function of the reconstructed thumbs nearly consistent with normal thumbs. But the operation influents the postoperative foot pressure.