CAJ | 학술논문

目的：探讨同蒂趾背甲皮瓣、趾侧方皮瓣在修复拇手指末节缺损中应用及疗效。方法：对12例拇手指末节缺损患者，应用吻合血管的同蒂趾背甲皮瓣、趾侧方皮瓣方法修复，趾背甲皮瓣及趾侧方皮瓣供区均采用游离植皮。结果：12例12指，趾背甲皮瓣及侧方皮瓣均成活，手部创面均1期愈合，1例甲皮瓣供区植皮部分坏死，经换药后愈合，所有病例经6个月～36个月随访，平均13个月，游离组织成活良好，指甲生长良好，指腹两点辨别觉恢复6～8mm，足部供区植皮无破溃，足部功能无影响。结论：采用同蒂趾背甲皮瓣、趾侧方皮瓣修复拇手指末节缺损是一种较好的临床方法，功能效果恢复满意。
목적：탐토동체지배갑피판、지측방피판재수복무수지말절결손중응용급료효。방법：대12례무수지말절결손환자，응용문합혈관적동체지배갑피판、지측방피판방법수복，지배갑피판급지측방피판공구균채용유리식피。결과：12례12지，지배갑피판급측방피판균성활，수부창면균1기유합，1례갑피판공구식피부분배사，경환약후유합，소유병례경6개월～36개월수방，평균13개월，유리조직성활량호，지갑생장량호，지복량점변별각회복6～8mm，족부공구식피무파궤，족부공능무영향。결론：채용동체지배갑피판、지측방피판수복무수지말절결손시일충교호적림상방법，공능효과회복만의。
Objective:To explore the clinical applications and outcomes of using the toe dorsal nail-skin flap and toe tibial flap based on one pedicle for repairing the defects of thumb and finger at the distal phalangeal level.Methods:Twlve fingers in 12 cases suffered from defect injury at the distal phalangeal level were reconstructed with the combined dorsal nail-skin flap and tibial flap based on one pedicle. The donor sites of the dorsal nail-skin flap and tibial flap were covered by full-thickness flap.Results:All second toe tibial flaps and hal-lux toe dorsal nail-skin flaps survived.The hand wounds healed well in one stage.The partial skin on the donor site of hallux toe dorsal nail-skin flap is necrosis in one case, and healed well finally through dressing.Patients were followed from 6 months to 36 months with an average of 13 months.All the free tissues survived.Appearance of the nail was satisfactory without deformity.2-PD of the finger pulp was from 6mm to 8mm.The donor sites of the flaps healed well without ulcer formation, and all the patients walled well.Conclusion:The hallux toe dorsal nail-skin flap combined with second toe tibial flap based on one pedicle is a valuable alternative for the reconstruction of the de-fects of thumb and finger at the distal phalangeal level with satisfactory results both functionally and cosmetically.