足背皮瓣联合第二足趾移植修饰性再造拇指

Aesthetic reconstruction of the thumb by transferring the second toe and dorsalis pedis flap

目的观察足背皮瓣联合第二足趾移植修饰性再造拇指的临床效果。方法对8例拇指Ⅴ、Ⅵ度缺如或伴有大面积皮肤缺损的患者，采用足背皮瓣联合第二足趾移植再造拇指，在切取第二足趾再造拇指时携带拇趾腓侧皮瓣，并将其嵌入第二足趾跖侧，消除第二足趾中段狭细的形态。结果8例再造的拇指及携带的皮瓣全部成活，术后随访6个月～2年，再造拇指外形非常满意，感觉恢复良好。结论足背皮瓣联合第二足趾移植是Ⅴ、Ⅵ度拇指缺损再造的良好方法，拇趾腓侧皮瓣嵌入第二足趾，使再造拇指外形更接近正常的拇指。

Objective To report the clinical therapeutic efficacy of reconstruction of the thumb by transferring the second toe and dorsalis pedis flap. Methods Twelve patients with Ⅴ °, Ⅵ ° thumb defect and large area skin defect were adopted to the second toe combined with dorsalis pedis flap transplant thumb reconstruction. To thicken the narrow of the second toe with great toe fibular skin flap embedded in it. Results All 8 cases of reconstructed thumbs of survived, postop follow - up visit 6 months to 2 years, the shape and sensory function were satisfactory. Conclusions The second toe combined with dorsatis pedis flap transplant repair complex thumb defect had been tested one good method for thumb reconstruction to Ⅴ °, Ⅵ ° thumb defect. The great toe fibular flap can wedged into the second toe and make its appearance more comparable to the normal thumb.