拇趾毁损伤的再造

Reconstruction of toe injury

目的介绍逆行足内、外侧双岛状瓦合皮瓣加髂骨植骨再造足拇趾外伤性缺损的临床经验。方法对拇趾及踌、第2趾毁损且跖趾关节完好者，采用以足背动脉跖底深支为蒂，以内踩前或跗内侧血管、外踝前或跗外侧血管为分支的足内、外侧分叶皮瓣瓦合加髂骨植骨再造足拇趾。结果术后皮瓣顺利成活，经6～18个月随访，再造足拇趾外形满意，皮瓣两点辨别觉6-8mm，X线示髂骨与残端趾骨骨性愈合，髂骨未见吸收征象．拇趾跖趾关节背伸达40°，屈曲达30°。结论采用逆行足内、外侧分叶瓦合皮瓣加髂骨植骨再造拇趾是一种简单有效的方法。

Objective To introduce the clinical experience of＂ reconstruction of toe injury by using reverse medial and lateral double island watte flap of foot combined with iliac bone graft. Methods For the patients with perfect metatarso-phalangeal joint except for injury of toe or toe and the second toe, we applied medial and lateral double island watte flap of foot combined with iliac bone graft for reconstruction toe, with the pedicle of deep branch of dorsal artery of foot, and with the branch of medial malleolus anterior or medial tarsal vessle, lateral malleolus anterior or lateral trasal vessle. Results The flaps survived after operation, fllowed-up for 6~18 months, the appearance of reconstruct toes were satisfactory, the two- discrmfination of flaps was 6-8ram, the iliac bone and stump phalanx bone was healing. There is no absorption phenomenon in iliac bone, and dorsiextension of metatarso-phalangeal joint was 40 degrees, and the flexion was 30 degrees. Conclusion It is a simple and effect method by using medial and lateral double island watte flap of foot combined with iliac bone graft for reconstruction of toe.