第一趾蹼皮瓣修复虎口挛缩

Repairing Contracture of the First Web of Hand with the Great/ Second Toe Web Flap

目的 :探讨吻合血管的第一趾蹼皮瓣修复虎口挛缩的方法和疗效。方法 :供区为第一趾蹼皮瓣。将皮瓣所携带的第一跖背动脉、大隐静脉和腓深神经分别与受区桡动脉腕背支、头静脉及桡神经浅支吻合。结果 :本组 32例皮瓣全部成活 ,经 1.0～ 3.5年随访 ,第一趾蹼游离皮瓣能满足保留虎口深度、展开度、良好感觉和美观外形的要求 ,临床效果较好。结论 :第一趾蹼皮瓣与虎口皮肤组织结构的厚薄及功用方面相似 ,是再造虎口的理想组织皮瓣。

Objective: To study the methods and therapeutic effect of repairing the contracture of the first web of hand by anastomosing its blood vessels with those of the great/second toe web flap. Methods: The donor site was the great/second toe web flap. The first dorsal metatarsal artery,saphenous vein and deep peroneal nerve in the flap were anastomosed with the wrist dorsal branch of radial artery,cephalic vein and superficial branch of radial nerve on the receptor site respectively.Results:The free skin graft of 32 patients in this group all survived. From 1-3.5years`follow-up survey it was shown that the great/second toe web flap could satisfy the demand of the first web of hand in terms of keeping certain depth,degree of extension and nice looking. Good clinical therapeutic effect was achieved.Conclusion: Similar with the skin tissue of the first web of hand in respects of histological structure,thickness and function,the great/second toe web free flap is an ideal skin flap for the repair of the first web of hand.