急诊第二足趾末节游离移植再造拇指指尖的临床研究

Clinical study of thumb tip defect reconstruction with free distal second toe in emergency

目的探讨急诊游离移植第二足趾末节再造拇指指尖缺损的临床治疗效果。方法根据拇指指尖部缺损大小、形状，设计第二足趾末节或者指尖急诊再造拇指指尖15例15指。第二足趾胫侧趾底动脉、神经与拇主要动脉及指固有神经吻合，吻合静脉主要以指（趾）背静脉为主，亦吻合指（趾）腹静脉。结果再造拇指指尖15例15指术后全部成活。随访3个月～3年，再造拇指指尖与正常指尖相似，指甲、指纹生长良好，两点分辨觉在4～6mm，对捏、持物功能良好。供足部功能无影响。结论应用第二足趾末节游离移植急诊再造拇指指尖，外形美观，功能恢复佳，手术方法简单，成功率高，可满足患者心理需求等优点。

Objective To discuss the clinical therapeutic efficacy of the clinical study of thumb tip defect reconstruction with free distal second toe in emergency. Methods Fifteen cases of thumb tip defect were reconstructed with free distal second toe in emergency. The blood supply was restored by anastomosis of digital and toe＇s artery and nerves, the dorsal surface and other side vein of fingers all can be anastomosed with toe＇s vein, but the first was main. Results All of fifteen fingers survived. Followed-up from 3 months to 3 years, all reconstruction thumbs has a satisfying outward appearance, normal nail and fingerprint, well pinch and hold functions, none effect to the foot. Conclusion Repair of thumb tip defects using free distal second toe in emergency enables favorable functional recovery and satisfying outward appearance, the method is simple and rats recover quickly.