微型坶甲瓣在拇指甲床重度缺损中的应用

Repair of severe nail bed defects of thumb with miniature wrap-around flap of toe

目的探讨应用微型坶甲瓣修复拇指甲床重度缺损的疗效。方法2008年7月-2013年4月，应用微型坶甲瓣修复拇指甲床重度缺损21例21指，吻合坶趾腓侧趾动脉-拇指固有动脉、跖背静脉-指背静脉、趾神经-指神经，供区均予第1跖背皮瓣逆行转移修复。结果微型罡母甲瓣全部成活，供区皮瓣有3例远端皮缘少许坏死，予换药后愈合。18例获得随访，随访时间6~12个月，拇指外形逼真，指甲生长好，患者对供区外观及功能满意。结论应用微型蹰甲瓣游离移植修复拇指甲床重度缺损，同时局部带蒂皮瓣修复供瓣区．是一种较理想的修复方法。

Objective To investigate the effect of miniature wrap-around flap of toe on repairing severe nail bed of thumb. Methods From July 2008 to April 2013, applying miniature wrap-around flaps of toe with Vascular and nerve anastomosis to reconstruct the thumb nail bed for 21 cases （21 fingers）. The donor sites were covered with first metatarsal dorsal flaps. Results Miniature wrap-around flaps of toe survived after surgery. 3 cases of flap of the donor site suffered little distal necrosis, and healed after dressing change. 18 cases were followed up, follow-up time of 6 months to 12 months. The appearance of thumb looked hke real one, the nails grew well; Patients were satisfied with appearance and function of the donor site. Conclusion The application of miniature wrap-around flap of toe to repair severe nail bed of thumb in emergency and cover the donor site with flap, is an ideal method.