摘要
目的 :探讨影响足趾再造部分手指外形和功能的关键因素 ,为临床治疗提供指导依据。方法 :通过对 2 8例39指再造指的手术经验和足趾与手指的比较解剖 ,对足趾移植再造部分手指的适应证、手术方法以及“驼背”畸形预防进行分析 ,并探讨改善再造指外形的整形方法和促进其感觉恢复的手段。结果 :足趾移植再造部分手指适合远侧指间关节以远的急诊毁损伤 ,供趾选择应按照优势侧动脉相吻合的原则。在骨关节重建时 ,应注重近侧指间关节的保留和重建 ,将趾短伸腱与受区侧腱束吻接有助于预防再造指“驼背”畸形。对供趾趾腹和趾根跖侧整形 ,可使再造指获得逼真的外形。术后感觉再教育是促进再造指感觉功能恢复的重要保证。结论 :足趾移植再造部分手指单纯追求成活并不困难 ,但是要想获得优良的外观和功能 ,必须对诸多相关问题进行妥善处理。
Objective: To investigate the factors affecting the appearance and function of reconstructed fingers using lesser toes transfer , and provide the direction for transfer surgery.Methods: According to the experience of 28 patients with 39 lesser toe-to-fingers transfer,as well as the comparative anatomy of lesser toe and finger,the transfer indication,operative technique and 'hump finger' prevention were retrospectively analyzed,simultaneously the appearance improving method and how to stimulate sensation recovery were explored and investigated. Results: Lesser toe-to-finger transfer wasoptimal for reconstruction the injury of distal to the proximal interphalangeal joint,the donor toe selection should adhere to the law of dominant artery interanastomosis.When bone and joint were repaired,the proximal interphalangeal joint must be maintained or reconstructed.Suturing of the extensor digitorum brevis to the recipient zone interosseous musculotendinous structure , helped to prevent the 'camel hump' appearance of the new fingers . Reducing the donor toe pulp and plantar of toe root contouring procedure were very crucial to aesthetic appearance of new fingers. The postoperative sensory reeducation could promote their sensation recovery. Conclusion: It is not difficult to only guarantee the survival of reconstructed finger from toe transfer , however ,the attainment of aesthetic appearance and fine function have to depend on deliberative disposal of every relevant factor.
出处
《中国矫形外科杂志》
CAS
CSCD
2003年第1期18-20,共3页
Orthopedic Journal of China
关键词
足趾移植
手指再造
显微外科手术
Finger
Toe
Transplantation
Reconstruction
Microsurgery
