CAJ | 학술논문

目的探讨应用足趾联合肩胛骨皮瓣进行手指伴手掌部分缺失修复重建的临床效果.方法切取肩胛骨皮瓣重建缺失手掌,切取双足2至4个足趾进行手指再造,一期完成手的修复重建.2010年6月至2013年3月对8例严重手指伴手掌部分缺失的患者应用该方法进行手的修复重建.结果 8例手修复重建全部存活.其中1例术后第1天发生血管危象,经重新探查吻合血管后存活.术后随访时间为6～12个月,手外形及功能恢复良好,按手指功能损害程度的综合评定,全部手功能由术前的10％上升到术后的60％,功能平均增加50％,极大地改善了手的功能.结论应用足趾联合肩胛骨皮瓣进行手指伴手掌部分缺失的修复重建是一种较好的方法.
목적 탐토응용족지연합견갑골피판진행수지반수장부분결실수복중건적림상효과.방법 절취견갑골피판중건결실수장,절취쌍족2지4개족지진행수지재조,일기완성수적수복중건.2010년6월지2013년3월대8례엄중수지반수장부분결실적환자응용해방법진행수적수복중건.결과 8례수수복중건전부존활.기중1례술후제1천발생혈관위상,경중신탐사문합혈관후존활.술후수방시간위6～12개월,수외형급공능회복량호,안수지공능손해정도적종합평정,전부수공능유술전적10％상승도술후적60％,공능평균증가50％,겁대지개선료수적공능.결론 응용족지연합견갑골피판진행수지반수장부분결실적수복중건시일충교호적방법.
Objective To investigate the clinical outcomes of reconstructing fingers and partial palm defect with combined transfer of toes and scapula osteocutaneous flap.Methods The scapula osteocutaneous flap was transferred to reconstruct the missing part of the palm of the hand.Depending on the number of fingers that were missing,2 to 4 toes were harvested from both feet and transferred to reconstruct the fingers simultaneously.From June 2010 to March 2013 a total of 8 cases of severely mutilated hand were reconstructed by this method.Results All the transplants in the 8 cases survived completely.Vascular crisis occurred within the first 12 hours postoperatively in 1 case.Surgical exploration and re-anastomosis of the vessel solved the crisis and led to transplant survival.Postoperative follow-up ranged from 6 to 12 months.Appearance and function of the reconstructed hands were good.Comprehensive evaluation of hand function based on severity of the defects indicated an improvement of whole hand function from 10％ to 60％,an average increase of 50％.Conclusion Combined transfer of toes and scapula osteocutaneous flap is a good technique for reconstructing fingers and partial palm defect.