带指固有动脉及神经的指侧方双页皮瓣转移再造拇指

Reconstruction Thumb with Finger Lateral Bilobed Skin Flap Transposition

目的 拇指是手部最重要的手指。基于对手部重建拇指解剖学的研究,应用手指侧方双页皮瓣转移再造拇指,并评价其治疗效果。方法 对8例外伤性拇指缺损,应用手指侧方双页皮瓣和自体髂骨移植再造,并于术后3个月观察其功能恢复情况、感觉恢复情况及两点辨别觉。结果 所有病例均一期愈合。3个月时,髂骨与自体骨愈合,患手可提起约10kg物体,感觉恢复,在同一皮瓣内两点辨别觉为2～3 mm,不同皮瓣间为5～7 mm。结论 手指侧方双页皮瓣可用于再造拇指,较传统方法具有操作简单,缝合张力小,有良好的两点辨别觉及外形美观等优点。

Objective The thumb is the most important finger in the hand. Based on the anatomical study for the reconstruction of thumb, we suggested the finger lateral bilobed skin flap to reconstruct thumb for the traumatically thumb defect, and evaluate its clinical effect. Methods From January 1995, we used the finger lateral bilobed skin flap transposition and iliac bone autograft to reconstruct thumb due to different traumatic accidence, three months after operation, we observed the function, sensation and two-point discrimination of the thumb. Results All cases gained primary union. On the three months after operation, the iliac bone and finger bone have union, the hand can left 10 Kg body, the sensation have restoration and the two-point discrimination is 2-3 mm in the same skin flap, and 5 - 7 mm between the different skin flap. Conclusion The finger lateral bilobed skin flap is an acceptable method to reconstruction thumb, and its advantage over other traditional methods are simple technique, tension-free skin cover, excellent two-point discrimination and aesthetically acceptable scars.