双足第2趾皮瓣瓦合修复手指Ⅰ度脱套伤

Repair of class I degloving injuries of fingers with dorsal and tibial flaps of the second toe

目的探索游离足第2趾甲背皮瓣联合对侧第2趾胫侧皮瓣瓦合修复单手指I度脱套伤的临床效果。方法 2009年3月至2012年6月,我科采用游离足第2趾甲背皮瓣联合对侧第2趾胫侧皮瓣瓦合修复单手指Ⅰ度脱套伤13例13指,并进行了随访。结果本组13例13指移植瓦合的皮瓣全部成活,经过6-24月随访,皮瓣颜色与正常手指相同,皮瓣无明显萎缩及色素沉着,除1例外形欠佳外,其余12例外形美观,13例指甲均生长良好,感觉恢复2-PD 6-10 mm,术后经理疗和功能锻炼,远指间关节伸屈活动良好,参照中华医学会手外科学分会拇、手指再造功能评定试用标准评定:优8指,良4指,可1指,优良率为92.3%,供区植皮全部成活,无瘢痕挛缩,无破溃,足趾无垂趾畸形,足部活动无影响。结论游离足第2趾甲背皮瓣瓦合对侧足第2趾胫侧皮瓣是修复单手指I°脱套伤的一种理想方法。

Objective To explore the treatment of class I degloving injuries of fingers with the free wrap-around flap of the second toe and the tibial flap of the opposite second toe. Method From March, 2009 to June, 2012, our department used the free wrap-around flap of the second toe and the tibial flap of the opposite second toe to repair class I degloving Injuries of fingers in 13 cases. All caes were followed up. Results After 6-24 months of follow-up, flaps underwent no significant atrophy, reconstructing full pulps; fingers were in good shape With nails growing well. The two-point discrimination was 6 to 10mm. According to the functional evaluation criteria by the Hand Surgery Society of Chinese Medical Association, the functional results were satisfactory in all patients （excellent in 8 cases, good in 4 cases, and satisfactory in 1 case ）, achieving an excellent and good rate of 92.3%. Donor sites of the toes healed well without scar contracture and no gait disturbance. Conclusion Using free wrap-around flaps of the second toe and tibial flaps of the opposite second toe to repair class I degloving Injuries of fingers is an ideal method.