CAJ | 학술논문

目的探讨对一指或多指的多关节毁损并伴有皮肤、肌腱、甲床等缺损的多处及复合组织缺损的重建与再造方法.方法从2007年8月至2010年8月,共收治单指或多指多关节复合组织缺损8例20指,均应用第二足趾的跖趾关节、近、远侧指间关节及其皮肤、肌腱、甲床等为供体,按受区所需进行分配并解剖、游离及拆分,然后分别移植到手指各缺损部位,进行血管、神经、肌腱等吻合,用一个足趾的不同组织修复一指或多指多部位、多组织的缺损.结果重建的20指术后均顺利成活,接近原手指外观及功能,足部供区外观及功能影响较小.随访3个月～3年,按手外科学会再造指功能评定试用标准评定:结果优16指,良3指,可1指.结论根据受区所需,拆分第二趾,对一指多处或多个手指进行再造与重建,效果满意,是一种修复一指多处或多指多处包括关节在内的复合组织同时缺损的理想方法.
목적 탐토대일지혹다지적다관절훼손병반유피부、기건、갑상등결손적다처급복합조직결손적중건여재조방법.방법 종2007년8월지2010년8월,공수치단지혹다지다관절복합조직결손8례20지,균응용제이족지적척지관절、근、원측지간관절급기피부、기건、갑상등위공체,안수구소수진행분배병해부、유리급탁분,연후분별이식도수지각결손부위,진행혈관、신경、기건등문합,용일개족지적불동조직수복일지혹다지다부위、다조직적결손.결과 중건적20지술후균순리성활,접근원수지외관급공능,족부공구외관급공능영향교소.수방3개월～3년,안수외과학회재조지공능평정시용표준평정:결과우16지,량3지,가1지.결론 근거수구소수,탁분제이지,대일지다처혹다개수지진행재조여중건,효과만의,시일충수복일지다처혹다지다처포괄관절재내적복합조직동시결손적이상방법.
Objective To investigate a method of repairing complex tissue defects one stage in one finger or several fingers for more fine recipient site repairing and less donor area traum. Methods From August 2007 to August 2010,eight cases of 20 fingers were reconstructed according to the state of complex tissue defects in a hand,second toes (right or left side) were split into two or three parts as complex tissue flaps that may including joints,tendons,skin,nail beds,et al.These flaps then were translated to hand to repair complex tissue defects by anastomosing vessels.Results Twenty fingers in 8 cases were successfully reconstructed.Follow-up ranged from 3 months to 36 months,external appearance were fine.According to the Trial Evaluation Standard of Reconstructed Finger Function of Handsurgery Society of China,sixteen fingers were excellent,three fingers were good,one finger was fine.And there was no effect on foot.Conclusion Spliting single second toe is a good method for repairing more complex tissue defects in a hand.