CAJ | 학술논문

目的介绍游离双足(踇)甲皮瓣组合移植再造拇指末节的术式.方法以健侧手指测量数据为依据,设计切取双足(踇)趾腓侧小部分骨甲皮瓣,通过“镜影式”组合两个复合组织瓣再造拇指末节.结果临床应用6例6指全部存活,术后随访3～9个月,再造拇指指腹饱满,两点分辨觉5～8mm,外形逼真,指甲生长良好,关节活动度正常.双侧(踇)趾供区直接缝合后均Ⅰ期愈合,双足(踇)趾对称,外观良好,关节活动无影响,无功能障碍.结论双足(踇)甲皮瓣组合移植再造拇指末节,供区创伤小,保留了(踇)趾外形和趾甲,再造拇指末节外形逼真,是再造手指较为理想的手术方式.
목적 개소유리쌍족(무)갑피판조합이식재조무지말절적술식.방법 이건측수지측량수거위의거,설계절취쌍족(무)지비측소부분골갑피판,통과“경영식”조합량개복합조직판재조무지말절.결과 림상응용6례6지전부존활,술후수방3～9개월,재조무지지복포만,량점분변각5～8mm,외형핍진,지갑생장량호,관절활동도정상.쌍측(무)지공구직접봉합후균Ⅰ기유합,쌍족(무)지대칭,외관량호,관절활동무영향,무공능장애.결론 쌍족(무)갑피판조합이식재조무지말절,공구창상소,보류료(무)지외형화지갑,재조무지말절외형핍진,시재조수지교위이상적수술방식.
Objective To introduce the surgical procedure of reconstructing the distal segment of the thumb using combined bilateral big toe wrap-around flap.Methods A partial fibular side wrap-around flap was harvested from both big toes.The flaps were tailored and designed based on measurements taken from the thumb of the intact side.These two flaps were combined like "mirror image" to reconstruct the distal segment of the thumb.Results This technique was used in 6 thumbs of 6 cases.All the transplants survived.The patients were follow-up for 3 to 9 months.All reconstructed thumbs had full pulp.Two-point discrimination was 5.0 to 8.0 mm.The appearance of the thumb looked real with normal growing nail.There was no impairment of joint movement and thumb function.Donor sites could be directly closed and healed uneventfully.No walking problems were encountered.Conclusion Reconstruction of the distal segment of the thumb using combined bilateral partial big toe wrap-around flap causes less trauma to the donor sites by preserving the shape and nail of the big toes.The appearance of the reconstructed thumb looks near normal.This surgical procedure is an ideal method for finger reconstruction.