CAJ | 학술논문

目的：探讨应用梭形趾腓侧皮瓣修复手指指端缺损的方法及疗效。方法2012年1月—2014年12月，采用梭形趾腓侧皮瓣修复手指指端缺损38例，皮瓣以梭形设计于趾腓侧，以趾腓侧趾底固有动脉为轴线，梭形皮瓣最宽处设计于趾趾腹周径最大处，术后趾供区可直接缝合。结果本组38例全部成活，术后随访6~18个月，移植的趾腓侧皮瓣颜色、质地与其他手指相近，外形满意，手指有指甲，指腹饱满，有螺纹，有出汗感觉，外形逼真，弹性好，可恢复精细感觉及功能，两点辨别觉恢复至4.0～6.0 mm。术后趾供区外形良好，仅留线形瘢痕，功能无影响。结论应用梭形趾腓侧皮瓣具有血管解剖恒定、切取方便、外形功能满意、供区损伤小等特点，改变既往趾供区植皮不易成活、易留瘢痕影响美观的缺点，是修复手指指端缺损的理想方法之一。
목적：탐토응용사형지비측피판수복수지지단결손적방법급료효。방법2012년1월—2014년12월，채용사형지비측피판수복수지지단결손38례，피판이사형설계우지비측，이지비측지저고유동맥위축선，사형피판최관처설계우지지복주경최대처，술후지공구가직접봉합。결과본조38례전부성활，술후수방6~18개월，이식적지비측피판안색、질지여기타수지상근，외형만의，수지유지갑，지복포만，유라문，유출한감각，외형핍진，탄성호，가회복정세감각급공능，량점변별각회복지4.0～6.0 mm。술후지공구외형량호，부류선형반흔，공능무영향。결론응용사형지비측피판구유혈관해부항정、절취방편、외형공능만의、공구손상소등특점，개변기왕지공구식피불역성활、역류반흔영향미관적결점，시수복수지지단결손적이상방법지일。
Objective To explore how to use the Spindle Hallux toe fibular skin flap to repair the fingertip defect and its clinical results. Methods From January 2012 to December 2014, we did surgical operation on 38 cases of fingertip defect by using spindle hallux toe fibular flap. The flaps were set to hallux toe fibular as the spindle-shaped flaps and used the bottom of hallux toe fibular artery as the axis. The widest point of the spindle-shaped flaps were set to the largest circumference of the toe abdomen. After the operation, the hallux toe for the area can be sutured directly. Results All of the 38 cases survived with satisfactory function. Followed up for 6 to 18 months, the transplanted hallux toe fibular flaps looked nearly the same as the fingers in color and texture, and had satisfactory shape. The fingers had nails, the pulp was plump and had screw thread. The fingers had sweat, good shape and good elasticity. It can regain fine feeling and function. Two-point discrimination can recover to 4~6 mm. The hallux toe for the area had fine shape after the operation, leaving only scar line. It didn't affect foot functions. Conclusion Spindle hallux toe fibular skin flap has many advantages. Fistly, it has constant anatomy. Secondly, it is easy to cut. It has good shape and satisfactory functions. Furthermore, the operation area has little damage. Compared with the Hallux toe skin graft, this method didn't have the disadvantages of fewer survivals and more scars. It is one of the ideal methods to repair fingertip defect.