半趾甲瓣移植修复手指末节半侧缺损

Reconstruction of semi distal segment defect of thumb and finger with semi skin-nail flap of toes

目的 探索对拇手指末节半侧缺损最佳再造、修复的方法。 方法 根据手指缺损程度的范围 ,切取趾腓侧及第二趾胫侧部分趾甲瓣移植 ,采用吻合趾 指血管的方法重建血液循环进行修复和重建。 结果 拇指半侧缺损采用趾腓侧趾甲瓣 3例 ,手指半侧缺损采用第二趾部分甲瓣 2例 ,拇指及中指末节背侧缺损采用趾及第二趾背侧甲瓣各 1例进行移植修复 ,全部成功。术后经 2个月～ 8年随访 ,手指外形基本恢复 ,外观较好 ,出汗有罗纹。 结论 采用趾腓侧第二趾部分趾甲瓣移植修复是治疗外伤后拇手指半侧和部分缺损比较理想的方法。

Objective To explore a better reconstructive procedure to reconstruct semi distal segment defect of thumb or finger Method According to the extent and degree of defect of distal segment of thumb and finger, a corresponding semi skin nail flap from hallux or second toe were harvested and transplanted by anastomosis between digital proper arteries of the donor and recipient digits Results Three cases of thumb defects reconstructed with semi skin nail flap of fibular side of hallux and two cases of defect of fingers reconstructed with that of tibial side of toe were performed with total success Follow up examination from 2 months to 8 years shown satisfactory outward appearance, normal sudomotor function and tactile discrimination from 4～6 mm All patients are gratifying for the result Concluson Reconstruction of semi distal segment defect of thumb and finger with semi skin nail flap of hallux or toe is most ideal altermative treatment at present