拇指严重缺失的组(联)合组织移植再造

Combined transplantation for thumb reconstruction in serious thumb defects

目的探讨应用游离第二足趾与游离皮瓣组(联)合移植再造拇指ⅡB及以上缺失合并虎口挛缩的方法。方法自1996年8月以来,共对8例ⅡB及以上拇指缺失合并虎口挛缩的病人进行拇指再造,其中应用游离第二足趾与股前外侧皮瓣组(联)合移植6例,与肩胛皮瓣组(联)合移植2例。结果8例手术均取得了成功,再造拇指与皮瓣存活,拇指功能良好,虎口平均扩大4.8cm。结论应用游离第二足趾与肩胛皮瓣或股前外侧皮瓣组(联)合移植的方法,是解决拇指ⅡB及以上缺失合并虎口严重挛缩的良好选择。

objective To introduce the method of thumb reconstruction in serious thumb defects with contracture of the first web space by using the second toe transplantation combined with the free flap.Methods From 1996, we had transplanted the second toe combined with free flap(scapular flap or anterior-lateral femur flap)for reconstruction of above ⅡB thumb defects in 8 cases. Results Eight reconstructed thumbs and flaps survived, and they all had got good function after rehabilitation, the first web space were widened for 4.8cm. Conclusion By using the second toe combined with scapular flap or anterior -lateral femur flap,it is a good solution to reconstruct thumbs, which were ⅡB thumb defects with first web space contracture.