游离踇趾甲皮瓣联合第2趾骨瓣再造拇指

Reconstruction of thumb by free hallux toenail flap combined with the second toe bone flap

目的 探讨踇趾甲皮瓣联合第2趾骨瓣再造拇指的方法 与疗效.方法游离踇趾甲皮瓣包裹第2趾骨瓣,再造拇指.供区第2趾剔骨皮瓣覆盖踇趾创面.2015年7月-2016年7月应用该方法再造拇指10例.缺损程度为Ⅱ度-Ⅳ度.结果 10例再造拇指全部成活,其中2例发生血管危象,经手术探查后再造指体成活.术后随访12-20个月,再造指体外形接近正常,活动度接近正常.两点辨别觉在5-8 mm.足部四趾,行走无疼痛,步态正常.结论 游离踇趾甲皮瓣联合第2趾骨瓣再造拇指,方法可靠,外形美观,疗效满意.

Objective To explore the effect of hallux toenail flap combined with the second toe bone flap for reconstruction of thumb. Methods Free hallux toenail flap wrapped the second toe bone flap for thumb reconstruction. The second toe bone flap covered hallux toe wound. From July 2015 to July 2016, 10 thumbs were reconstructed by this method. Results Reconstruction in all survived, of which 2 thumbs had vascular crisis, survived after exploratory operation. Followed-up for 1 to 2 years, the shape and activity of the reconstructed thumb was close to normal. Two point discrimination was 5-8 mm. Donor site was no pain and normal gait. Conclusion The method of free hallux toenail flap combined with second toe bone flap for reconstruction thumb was reliable, shape and curative effect of thumb is satisfactory.