CAJ | 학술논문

目的探讨跖趾关节全关节移植重建掌指关节的术式.方法自2006年3月至2012年8月,采用吻合血管的第2足趾全跖趾关节原关节重建手指掌指关节外伤性缺损8例,采用(足母)甲皮瓣联合第2趾骨、跖趾关节和肌腱再造Ⅴ度以上拇指重度缺损5例,共13例第2跖趾关节移植的病例,术中未予跖骨头下截骨及跖背侧倒置,术后进行系统康复训练.结果移植的关节全部存活(均携带背侧皮瓣),4例患者分别在术后3～6个月行肌腱粘连松解术.10例经1～5年的随访,主动活动范围最大80°,最小45°,平均60°.按中华医学会手外科学会功能评定试用标准进行评定:优3例,良6例,差1例.结论全跖趾关节原关节移植重建指掌指关节可取得良好的治疗效果.
목적 탐토척지관절전관절이식중건장지관절적술식.방법 자2006년3월지2012년8월,채용문합혈관적제2족지전척지관절원관절중건수지장지관절외상성결손8례,채용(족모)갑피판연합제2지골、척지관절화기건재조Ⅴ도이상무지중도결손5례,공13례제2척지관절이식적병례,술중미여척골두하절골급척배측도치,술후진행계통강복훈련.결과이식적관절전부존활(균휴대배측피판),4례환자분별재술후3～6개월행기건점련송해술.10례경1～5년적수방,주동활동범위최대80°,최소45°,평균60°.안중화의학회수외과학회공능평정시용표준진행평정:우3례,량6례,차1례.결론전척지관절원관절이식중건지장지관절가취득량호적치료효과.
Objective To explore the effects of whole metatarsophalangeal joints transplantation to reconstruct metacarpophalangeal joints.Methods From March 2006 to August 2012,8 patients received metatarsophalangeal joints of the second-toe transplantation to reconstruct the metacarpophalangeal joints.5 patients with level Ⅴ thumb defect were given a comprehensive transplant surgery consisting of the wraparound flap of the first toe and all bone,joints and tendons of the second toe.None of the 13 patients received osteotomy beneath the head of metatarsus and palm dorsal inversion.All cases underwent a systematic protocol of rehabilitation after operations.Results All transplants survived,of which 4 cases received tenolysis 3 to 6 months after operations.In 10 patients after 1 to 5 years follow-up,the average active joint motion was 60° (range,45°to 80°).The outcomes were graded as excellent in 3 cases,good in 6 cases,and poor in 1 case according to the provisional functional assessment criteria for upper limbs issued by the Hand Surgery Society of Chinese Mledical Association.Conclusion Metatarsophalangeal joints transplantation to reconstruct metacarpophalangeal joints is an effective method without osteotomy and palm dorsal inversion.