CAJ | 학술논문

目的探讨解决先天性或创伤所导致的残缺手与手指骨缺损、外形残缺和功能受限的问题,以及通过再造恢复其外形及功能的手术方法. 方法采用自体游离或带血管髂骨与皮瓣组合、带血管跖趾关节或游离足趾与皮瓣组合等方法一期或分期再造残缺手与手指.用局部或游离皮瓣或串联皮瓣重建缺损的软组织,同时修复关节囊及肌腱缺损. 结果术后除1例因严重感染失败,其余全部成活.15例中13例经8个月～2年随访,按照中华医学会手外科学会断指再植功能评定试用标准评价结果 :运动功能优2例,良5例.感觉功能:优(S5)8例,良(S4)1例.外观评价:优4例,良5例. 结论采用自体骨与皮瓣组合、自体足趾及关节移植与皮瓣组合等方法再造残缺手与手指,能最大程度的恢复手部外形及一定的功能,减低手和手指残缺率.
목적 탐토해결선천성혹창상소도치적잔결수여수지골결손、외형잔결화공능수한적문제,이급통과재조회복기외형급공능적수술방법. 방법 채용자체유리혹대혈관가골여피판조합、대혈관척지관절혹유리족지여피판조합등방법 일기혹분기재조잔결수여수지.용국부혹유리피판혹천련피판중건결손적연조직,동시수복관절낭급기건결손. 결과 술후제1례인엄중감염실패,기여전부성활.15례중13례경8개월～2년수방,안조중화의학회수외과학회단지재식공능평정시용표준평개결과 :운동공능우2례,량5례.감각공능:우(S5)8례,량(S4)1례.외관평개:우4례,량5례. 결론 채용자체골여피판조합、자체족지급관절이식여피판조합등방법 재조잔결수여수지,능최대정도적회복수부외형급일정적공능,감저수화수지잔결솔.
Objective To explore and solve the problem of insufficiency and malformation due to cripple hand and defect of digital bone resulted of innate and injured. Evaluation to the methods of bone autografting combinated with flaps to reconstruct the deficient hand and digits. Methods Vascularized iliac bone or metatarsophalangeal joints (MPJ) or toes transplantation incorporated with flaps were used to reconstruct the defected bone in palm or fingers. Combined with tendon absence in such cases should be repaired or restituted by tendon autografting in one stage or by stages. Results Total 16 cases were treated by the methods metioned above. Except 1 of 16 was failure resulted in severe infection, the others were reconstructed successfully. 13 of 16 were followed up 8 months to 2 years, the evalution of the group from motion,sensation and appearance shew that the fine rate of motion was 53.8 percent, the rate of appearance and sensation were both 69 percent. Conclusion Vascularized iliac bone or metatarsophalangeal joints (MPJ) or toes transplantation incorporated with flaps are available to reconstruct the defected bone in palm or fingers, and can reduce disability effectively while obtain a satisfactory outlook and proper functions by those methods.