足趾组织再造拇手指及其功能重建

The results of thumb and finger reconstrution by the modified great toe fibular flap

目的探讨与研究足趾组织再造拇手指及其功能重建的手术方法以及手术效果。方法本文选择了70例拇手指损伤患者进行研究,对这些患者进行足趾组织再造拇手指手术,首先切取患者足趾,与此同时,游离并且将趾腓侧切取八角或者是四角形的带翼状组织瓣,再在足趾跖侧嵌入趾腓侧皮瓣,在足趾跖腹侧相应的位置上嵌入多角形的趾腓侧皮瓣,而带翼状组织瓣则嵌入到两角间的皮肤之下。结果本文选择的这70例71指以及进行嵌入手术的趾腓侧皮瓣都得以存活,在手术结束后的3～12个月进行随访,接受手指、拇指再造手术的患者,其外形在不同程度上得到了改善,并且与健侧的手指以及拇指非常接近。结论足趾组织再造拇手指及其功能重建的手术方法简单、效果可靠,在不同程度上改善了足趾的狭细外形。可以保证患者对拇手指美观以及功能的两重要求。值得在临床上实施与推广。

Objective To evaluate and investigate the methods and results of thumb and finger reconstruction by the modified great toe fibular flap. Methods 70 patients were received the modified great toe fibular flap, the four-angle or eight-angle great toe fibular skin flap with winging form was mobilized and harvest when the toe was transferred, and then wedged into the toe at the plantar side. The four-angle flap was inserted into the plantar aspect of the toe, while the winging form great toe fibular flap was inserted below the skin at the two angles. Results 71 reconstructed thumb and fingers in 70 patients and all the great toe fibular flaps sur- vived uneventfully. Patients were followup for 3 months to 12 months after the operation. The contour of the reconstructed thumb and fingers was improved, comparing to that from conventional toe transfer. The appearance was close to that of thumb or fingers on the uninjured side. Conclusion The methods of the great toe fibular flap are simple effective and safe. It can be wedged into the toe to not only improve narrow appearance at the middle portion of the toe, but correct flexion deformity as well.