皮管和指(趾)甲移植再造手指

Reconstruction of fingers with replanting skin tube and nail

目的报道皮管和指(趾)甲移植再造手指的方法及功能。方法利用无再植条件的断指指骨或髂骨作骨架固定,置入对侧腋下皮管,将断指甲床或取足趾甲床移植再造手指。结果本组再造42指皮瓣全部成活,移植指(趾)甲全部成活35指,部分成活5指,失败2指。术后经6个月～4年随访,再造手指功能良好,半年后恢复保护性感觉,外形美观,病人对疗效满意。结论此方法设计合理,不需吻合血管、神经,功能恢复良好,外形美观,尤其适于末节指体损伤或缺失,是一种再造手指的较好方法。

Objective To explore how can increase the successf ul rate of fingers reconstruction by using compound tissue.Methods To restore d fingers by waste finger bone or ilium combined with tube flaps and residual f ingernails(toenails).Results In this team of 42fingers reconstruction all f laps survived,35fingernails(toenails)survived,5par-tially survived and2 fingers failed.The postoperative following-up period was6to48months.The fu nction and shape of fingers were satisfactory.After6months,protective sensat ion returned to the restored fingers.Conclusion The design is reasonable.witho ut vascular anastomosis and nerval suture,good shape and function can be obtai ned not to anasto mose the vascu lar and nerve.It is an ideal method to restor e fingers especially to the finger with dista l part defect.