介绍几种残指延长拇指再造的方法

Methods for thumb reconstruction

本文报告带血管神经蒂组织瓣移位及手残指缓慢长术治疗６４例拇指缺损，拇指平均延长２．６CＭ平均随访时间３年６个月，再造拇指外形及功能均较满意。本法简单，安全、有效。拇指掌指关节以远缺如，残端指骨延长术，不足１ＣＭ者可行第１掌骨延长术，二期行虎口加深术。掌指关节平面缺如采用第１掌骨延长术或带血管蒂皮瓣移位再造拇指。也可用带桡骨片的前臂桡侧皮瓣一期再造拇指。第１掌骨近侧平面缺如，由于骨缺损较多不宜选用残指延长术，以游离足趾移植再造拇指为首选。

We report 64 cases of thumb reconstructions either by transfers of tissue-flaps with pedicled vessels or by gradual extension of defective thumbs The new thumbs were averagely 2.6 cm longer than before. The configurations and functions of reconstructed thumbs were satisfactory. Our techniques of thumb reconstruction were simple, safe and efficient. In cases that the defects were distal to metacarpophalangeal joint, if more than 1cmphalanx were remained phalangeal extension technique would be chosen ifless than 1cm metacarpal extension would be chosen with secondary first web deep-dial forearm flap with bone block from radius would be adopted. Fordefects proximal to metacarpophalangeal joint, free toe transplantation would be of choice.