CAJ | 학술논문

目的：探讨应用改良第2跖趾关节背侧复合组织瓣移植修复掌指关节背侧缺损的方法及临床疗效。方法2006年6月—2013年6月，采用改良的第2跖趾关节背侧复合组织瓣修复24例25处掌指关节背侧缺损。术后定期随访并进行功能评定。结果本组25处复合组织瓣全部成活，切口均一期愈合，供足植皮成活良好。全部病例得到随访，随访时间6~48个月，X线片提示骨骼愈合，重建掌指关节均获得较好的功能恢复。按中华医学会手外科分会拇手指再造功能评定试用标准评定优良率为92.0%。供足外形及功能无明显影响。结论采用改良第2跖趾关节背侧复合组织瓣移植修复拇手指掌指关节背侧缺损，虽然手术风险较大，但能最大限度地修复关节外形、恢复功能，值得临床推广应用。
목적：탐토응용개량제2척지관절배측복합조직판이식수복장지관절배측결손적방법급림상료효。방법2006년6월—2013년6월，채용개량적제2척지관절배측복합조직판수복24례25처장지관절배측결손。술후정기수방병진행공능평정。결과본조25처복합조직판전부성활，절구균일기유합，공족식피성활량호。전부병례득도수방，수방시간6~48개월，X선편제시골격유합，중건장지관절균획득교호적공능회복。안중화의학회수외과분회무수지재조공능평정시용표준평정우량솔위92.0%。공족외형급공능무명현영향。결론채용개량제2척지관절배측복합조직판이식수복무수지장지관절배측결손，수연수술풍험교대，단능최대한도지수복관절외형、회복공능，치득림상추엄응용。
Objective To explore a new improved technique and its clinical effect on the treatment of composite tissue dorsal defects in the metacarpophalangeal joint by transplantation of the second metatarsophalangeal joint. Methods From June 2006 to June 2013, According to the damage characteristic of metacarpophalangeal joint, twenty-five joints of 24 cases were repaired using the improved second metatarsophalangeal joint composite flaps, and the cases were follow-up on a regular basis and functional assessment. Results The composite flaps in 24 cases survived, incision healed, all graft skin survived well. The patients were followed up for 6 to 48 months, and no joint degeneration in X-ray manifestation occured and the recovery of joint function is satisfactory. According to the function evaluation standard of reconstraction of thrumb and finger issued by Hand Surgery Society Chinese Medical Association, the excellent and good rate was 92.0%. There was no influence on donor foot function and appearance. Conclusion Although there is operation risk, but after the rapairing, it can maximize the recovery of appearance and function. So transplantation of the second metatarsophalangeal joint is a kind of technique and were popularization to treat composite tissue dorsal defects in the metacarpophalangeal joint.