手指末节缺损的修饰性再造

Aesthetic reconstruction of distal finger defect

目的：探讨手指末节缺损修饰性再造方法和临床疗效。方法根据手指末节缺损部位、层面、外形，设计甲瓣、第2，3足趾末节或足趾末节部分游离组织瓣，急诊或择期移植再造手指末节21例21指，采用趾—指动、静脉吻合方式重建血液循环。结果再造指体21例21指全部成活。术后随访3个月～3年，再造末节指体指腹饱满，外形逼真，指甲生长良好，皮肤两点辨别觉8～10 mm，末节功能良好。结论应用甲瓣、第2，3足趾末节或足趾末节部分游离组织瓣移植再造手指末节是较理想的方法。

Objective To report the method and effect of aesthetic reconstruction of distal finger with 2nd, 3rd toe or hallux toenail flap transplantation. Methods In a series of 21cases of distal finger defect, 21 fingers were reconstructed with transplantation of 2nd, 3rd or hallux toenail flap according to the appearance of donor toe. The blood-supply Was restored by anastomosis of digital artery and vein. Results All reconstructed fingers survived. 21 patients have been followed up from 3 Months to 3 years postoperatively. The finger pulp was plump and elastic, the appearance was realistic, all feelings were recovered, two-point discrimination was 8 to 10 millimeter. The distal finger recovered good function. Conclusion For aesthetic reconstruction of distal finger, the 2nd, 3nd toe or hallux toenail flap is an ideal method.