指固有血管蒂筋膜瓣营养甲床移植修复指甲缺损

Nail bed transplantation nourished by fascial flap pedicled with proper digital vessels for repair of nail defects

目的探讨指固有血管蒂筋膜瓣联合甲床移植修复指甲缺损的疗效。方法自2012年1月至2016年3月，我们共收治甲床缺损患者25例27指，均伴有末节指骨骨膜缺损，采用指固有血管蒂筋膜瓣联合甲床移植修复，重建甲床。结果术后27指移植甲床全部存活，随访时间为6～24个月，平均12．5个月，指甲外观满意。根据吕桂欣等的方法进行甲床存活及指甲外形功能疗效评定：优16指，良9指，差2指，优良率为92．6％。结论应用指固有血管蒂筋膜瓣联合甲床移植修复伴有指骨骨膜缺损的甲床缺损，术后疗效满意，可最大限度地恢复指甲外观及功能。

Objective To explore the clinical effects of nail bed transplantation combined with fascial flap pedicled with proper digital vessels in the treatment of nail defects. Methods From January 2012 to March 2016, 25 cases （27 fingers） of nail bed defects accompanied with phalangette periosteum defects were treated by nail bed transplantation combined with fascial flap pedicled with proper digital vessels. Results Postoperatively transplanted nail bed in 27 fingers survived. The patients were follow-up for 6 to 24 months with an average of 12.5 months. The nail appearance was satisfactory. According to the evaluation method issued by Lv Guixin et al, the curative effect of nail bed survival and nail shape was rated as excellent in 16 fingers, good in 9 fingers and poor in 2 fingers with the excellent and good rate being 92.6%. Conclusion The application of nail bed transplantation combined with fascial flap pedicled with proper digital vessels in the treatment of nail defects accompanied with phalangette periosteum defects can maximally restore the appearance and function of the nails. The postoperative clinical effects are satisfactory.