（足母）趾胫侧逆行岛状筋膜皮瓣修复坶趾远端缺损

Repair of distal defect at the first toe with digital reverse fasciocutaneous flap of the first toe

目的 介绍（足母）趾胫侧血管逆行岛状筋膜皮瓣修复（足母）趾远端缺损的手术方法及临床疗效.方法 自2006年1月-2008年6月,对6例应用（足母）趾胫侧血管逆行岛状筋膜皮瓣修复（足母）趾远端缺损.在第1跖骨胫背侧设计皮瓣,自甲根部胫侧缘至第1跖骨胫侧缘的连线为轴心线,轴点位于趾间关节近侧0.5cm以近的轴心线上,切取的皮瓣内含有足背内侧皮神经的（足母）趾背胫侧支及第1跖背动脉在趾跖关节分出的（足母）趾背胫侧支,转移后与创面腓侧（足母）趾趾底固有神经接合.结果 6例皮瓣全部成活,随访6～21个月,皮瓣质地柔软耐磨,感觉恢复好,皮瓣无臃肿,外观好,趾跖关节活动正常.结论 该皮瓣具有不损伤主要动脉、神经,操作简单,质地良好,外观佳,血供可靠等优点,重建趾腹感觉恢复满意,是修复趾端软组织缺损较好的方法.

Objective To introduce the surgical method and clinical effect of digital reverse fasciocutaneous flap of the first toe repairing the distal defect at the first toe. Methods From January 2006 to June 2008,6 patients were applied with the flap. Designing flap from digital dorsal of the first metatarse ,the thread from the digital nail root to the first metatarse is the axle thread,the axle point located in the axle thread nearing the toe joint 0.5cm, the flap including the branch of digital dorsal of the first toe which from the dorsalis pedis cutaneous nerves and the branch of digital dorsal of the first toe which is separated in metacarpophalangeal joint from the first metatarsal dorsal artery, the flap was sutured with digital planta nerves of lateral dorsalis of the first toe. Results The flap all survived. They were followed up for 6 to 21 months. The countour and sensory of flap recovered satisfactory and the moving of metacarpophalangeal joint is normal. Conclusion The flap is a realisable flap with easy operation and good outward appearance and feeling, not injury major artery and nerves, so it is a good method to repairing the distal defect at the first toe.