跖-掌血管吻合急诊再造手指

The emergency reconstruction of damaged fingers using toe transplants with anastomoses of plantar and palmar vessels

目的：探讨采用跖-掌血管吻合游离足趾急诊再造手指的方法和疗效。方法2007年2月-2012年4月，对48例56指毁损的患者采用跖-掌血管吻合（即足部的第1跖骨背动脉或趾固有动脉与指总动脉吻合，跖背静脉与掌背静脉吻合）的方法，游离第2足趾急诊修复再造手指。结果术后48例56指全部成活，成活率100%，术后随访6个月～3年，再造指指腹饱满血运良好，依据中华医学会手外科学会拇手指再造功能评定试用标准评定，再造手指优51指，良3指，可2指，优良率91%。结论对于食中环指的Ⅳ＆#176;、Ⅴ＆#176;、Ⅵ＆#176;缺损应用跖-掌血管吻合急诊修复再造是简捷可靠的方法。

Objective To investigate the clinical result of using toe transplant with vascular anastomoses to reconstruct damaged fingers in emergency situation. Methods From February 2007 to April 2012, the technique of the second toe transplant with vascular anastomoses of plantar and palmar vessels （anastomoses of the first dorsal metatarsal arteries or the proper digital arteries and digital total artery, as well as the dorsal metatarsal veins and the digital metacarpus dorsal veins） were used to reconstruct the 56 damaged fingers in 48 patients. Results All the transplant fingers survived, with 100% survival rate. The postoperative following-up periods ranged from 6 months to 3 years. According to the reconstructed function of fingers evaluation of Hand Surgery Society in Chinese Medical Association, the reconstructed function of fingers graded excellent in 51 cases, good in 5 cases and fair in 2 cases, with an overall 91% excellence rate. Conclusion Using toe transplant with anastomoses of plantar and palmar vessels was convenient and reliable to reconstruct number 2,3 and 4 fingers with defects ranging from Ⅳ＆#176;toⅥ＆#176;.