CAJ | 학술논문

目的探讨一种保留供区(母)趾长度的Ⅱb度拇指缺损再造的手术方法和疗效. 方法 2012年3月至2014年2月,对11例Ⅱb度的拇指缺损(根据顾玉东分型法)采用游离的同侧(母)甲瓣加同侧游离的髂骨条进行再造,其中8例为闭合创口,3例为开放创口.供区(母)趾皮肤缺损采用游离的同侧旋髂浅动脉穿支皮瓣修复,腹部供区直接缝合. 结果术后11例再造拇指全部成活,11例皮瓣有1例出现动脉危象,2例出现静脉危象,经过手术探查后全部成活,术后随访3～15个月,再造拇指外观良好,感觉恢复S3+,两点辨别觉6～8 mm,拇指对掌、对指功能良好,根据中华医学会手外科学会手部功能评定标准:优8例,良3例,供区(母)趾皮瓣色泽、质地较满意,但略显臃肿,不影响行走及跑步,有4例患者进行了皮瓣修整,外观更加良好,腹部只存留一线性瘢痕,无明显不适. 结论用游离同侧(母)甲瓣加游离的同侧髂骨条再造Ⅱb型拇指缺损,游离同侧旋髂浅动脉穿支皮瓣修复供区皮肤缺损,再造拇指外观功能良好..
목적 탐토일충보류공구(모)지장도적Ⅱb도무지결손재조적수술방법화료효. 방법 2012년3월지2014년2월,대11례Ⅱb도적무지결손(근거고옥동분형법)채용유리적동측(모)갑판가동측유리적가골조진행재조,기중8례위폐합창구,3례위개방창구.공구(모)지피부결손채용유리적동측선가천동맥천지피판수복,복부공구직접봉합. 결과 술후11례재조무지전부성활,11례피판유1례출현동맥위상,2례출현정맥위상,경과수술탐사후전부성활,술후수방3～15개월,재조무지외관량호,감각회복S3+,량점변별각6～8 mm,무지대장、대지공능량호,근거중화의학회수외과학회수부공능평정표준:우8례,량3례,공구(모)지피판색택、질지교만의,단략현옹종,불영향행주급포보,유4례환자진행료피판수정,외관경가량호,복부지존류일선성반흔,무명현불괄. 결론 용유리동측(모)갑판가유리적동측가골조재조Ⅱb형무지결손,유리동측선가천동맥천지피판수복공구피부결손,재조무지외관공능량호..
Objective To evaluate the clinical outcome of a method of renconstruction of Type Ⅱb defect of thumb both and reserving the length of the donor toe.Methods From March 2012 to Febrary 2014,there were 11 cases of thumb defect treated in our hospital.According to Gu Yudong's classification,all were type Ⅱ b.Three were open defect and others were closed defect.All were treated with combined transfer of big toe wrap-around flap and autogenous iliac graft for thumb reconstruction while a superficial circumflex iliac artery perforator flap was used to resurface the donor defect.The donor site of the belly was sutured directly.Results All of the reconstructed thumb survived.Among 11 flaps,arterial crisis occurrred in 1 case,venous crisis occurred in 2 cases,and all survived after operative treatment.The patients were followed-up from 3 mooths to 15 months,all the thumbs had a good appearance.The thumb opposition function was good and sensation recovery to S3 + and two-point discrimination from 6-8 mm.The donor big-toe was preserved.All the flaps had satisfactory color and texture,but looked a little plump.All the patients had no effect on walking and running.Four flaps had more beautiful appearance after flap plastic.There was only one linear scar on the belly donor without any discomfort.Conclusion It is an effective method of combined transfer of big toe wrap-around flap and autogenous iliac graft while a superficial circumflex iliac artery perforator flap was used to resurface the donor defect used to reconstrucution of Type Ⅱ b defect of thumb is very good.