第2足趾重塑后再造拇指的临床研究

Clinical research of thumb reconstruction with transplantation of the second toe after plastic operation

目的探讨重塑第2趾后再造拇指的新术式。方法对12例再造手指,利用第2跖背动脉或第2趾底总动脉在第3足趾发出的分支的血管,设计局部转移皮瓣,将其嵌入第2足趾中节的腓侧,以增加第2足趾的周径;利用趾背动脉之间、趾背与趾足底动脉之间、趾足底动脉之间存在的吻合,设计趾腹皮瓣,将其嵌入第2足趾跖侧,消除再造手指狭细的形态;将第2足趾整形后,再移植于手部,再造拇指。结果 12例18指,32个局部转移皮瓣全部成活,供区第3足趾血运无影响,再造手指外形非常满意。结论以第2、3足趾局部转移皮瓣将第2足趾整形,再进行拇指再造,此法是改善再造手指外形的良好方法 。

Objective To introduce a new method for thumb reconstruction with transplantation of the second toe after plastic operation.Methods Local transfer flap was designed and embedded in reconstructed finger on fibular side to enlarge its circumference and the simepulp flap was designed and inserted into reconstructed finger on plantar side to eliminate middle stenosis in 12 cases according to the anastomosis between dorsal digital arteries and proper plantar digital arteries in superficial fascia.The second toe was transplanted to reconstruct the thumb after plastic operation.Results All the 32 toe local transfer flaps in 12 cases survived and the shape of the reconstructed thumb was satisfactory.Conclusion It is a good method to reconstruct thumb using the second toe reshaped by local transfer flap.