足趾移植再造拇指的临床分析

Clinical analysis of thumb reconstruction with toe transplantation

目的报道足趾移植治疗拇指缺损的临床效果。方法我院于2000～2002年,共施行足趾移植再造拇指术15例,其中应用改良甲瓣再造拇指5例,第二足趾移植再造拇指10例;急诊一期修复4例,延迟修复6例,二期修复5例。术后均行系统的康复治疗。结果再造拇指15例全部成活,经过1年以上的随访,移植足趾和甲瓣恢复触、痛、温觉,两点辨别觉为6mm～10mm,所有病例恢复了对掌、对指功能,日常生活能够自理。结论术前详细检查、合理设计,术中无创伤操作及对变异血管的正确处理是获得足趾移植成活的关键。

Objective To report the clinical effect of toe transplantation in treatment of thumb defect.Methods From2000to2002,15cases with thumb defect were treated with toe transplantation,of which modified hallucal wrap around flap was applied in5cases,the second toe was transplanted in10cases.Of total cases,there were4cases in primary repair,6patients in delayed repair,5patients in secondary repair.Comprehensive rehabilitation was done postoperatively.Results All15cases survived.After more than one year following-up,the sensation of pain and temperature were recovered in the transplantation toe and wrap aroud flap,the two -point discrimination was6-10mm,the function of pinch and oppose was restored.Conclusion It plays a key role in the toe transplatation for careful examination and reasonable design of reconstruction plan,and fine manipulation to protect blood vessels from trauma,correct dispose of abnormal blood vessels.