（足母）趾底动脉背侧支供血的（足母）甲瓣修复拇和手指甲床及软组织缺损

Reconstruction of thumb and finger nail defects by using hallux toenail flap transplantation with dorsal branch of proper plantar artery anastomosis

目的 探讨由（足母）趾趾底动脉背侧分支供血的（足母）甲瓣移植修复拇、手指甲床及周围皮肤软组织缺损的方法及疗效. 方法 2010年1月至2012年10月,采用由（足母）趾趾底动脉背侧分支供血的足趾甲瓣游离移植修复3例拇指、9例手指甲床及周围皮肤软组织缺损；（足母）趾供区采用直接缝合、全厚皮植皮、（足母）趾腓侧瓣覆盖等方法修复,并进行了随访. 结果 术后（足母）甲瓣全部完全成活经过4～14个月随访,功能良好,12例趾甲全部生长,9例趾甲平整,外形满意,2例趾甲不平整,1例缝合口瘢痕增生挛缩明显,（足母）供区植皮、皮瓣修复处无磨损破溃发生. 结论 （足母）趾趾底动脉背侧分支供血的（足母）趾甲瓣游离移植修复拇、手指甲床及周围皮肤软组织缺损是一种损伤较小、方法可靠的治疗方法.

Objective To evaluate the method and clinical effect of hallux toenail flap transplantation with dorsal branch of proper plantar artery anastomosis in the reparation thumb and finger nail defects.Methods From January 2010 to October 2012,three cases with thumb nail defects and 9 cases with finger nail defects were repaired by the hallux toenail flap transplantation.The dorsal branch of proper plantar artery of toenail flap was anastomosed with proper palmar digital artery or dorsal branch of proper palmar digital artery; using suture,dermatoplasty and hallux fibular flap to repair the donor site of hallux.Results All 12 cases of grafted hallux toenail flaps survived.All patients revealed favorable functions and growth of nail,nine cases of the grafted hallux toenail appearance was smooth and outline were satisfied,two case of the grafted hallux toenail was not smooth,one case of the grafted hallux toenail was obvious contracture and scar hyperplasia around the suture after 4-14 months followed-up,there was no abrasion to break happened in the area of dermatoplasty and flap.Conclusion It is a smaller injury and reliably method that using hallux toenail flap transplantation with dorsal branch of proper plantar artery anastomosis to repair the thumb and finger nail defects.