精细再造拇指25例报道

The experience of thumb fine reconstruction in 25 cases

目的探讨利用游离[足母]甲皮瓣及游离笫2足趾带[足母]趾腓侧皮瓣联合再造拇指的临床疗效。方法自1999年7月-2008年4月利用游离[足母]甲皮瓣修复拇指脱套伤21例，利用[足母]趾腓侧皮瓣嵌入第2足趾改形再造拇指4例，术中将皮瓣内携带的四趾腓侧趾底神经与受区内侧指神经行外膜吻合，重建再造指感觉。结果临床应用25例，再造拇指全部成活，外形逼真，经吻合神经后皮瓣恢复部分感觉，功能恢复良好。结论利用游离[足母]甲皮瓣修复拇指脱套伤及游离第2足趾带[足母]趾腓侧皮瓣联合再造拇指，是再造拇指较理想的术式。

Objective To study the clinical results of the thumb reconstruction with wrap-around flaps of the toe and the second toe wedged by fibular side flap of the toe.Methods From July 1999 to April 2008,21 cases of thumb degloving injuries were repaired with wrap-around flaps of the toe, and 4 cases were reconstructed with the second toe wedged by fibular side flap of the toe. We anastomosed the nerve of fibular side flap of the toe with the medialis digital nerve of recipient site to restore the flap sense. Results All flaps survived, with satisfactory contour and function of the hand as well as satisfactory thumb sense.Conclusion Wrap-around flaps of the toe and the second toe wedged by fibular side flap of the toe is the optimal method of the thumb reconstruction.