Finger Reconstruction with a Free Neurovascular Wrap-Around Flap from the Big Toe
Finger Reconstruction with a Free Neurovascular Wrap-Around Flap from the Big Toe
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使用大脚趾的游离神经血管包裹皮瓣进行手指重建
DOI：
10.1055/s-2001-16022
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发表时间：
2001
期刊：
影响因子：
--
通讯作者：
E. Kang
中科院分区：
文献类型：
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作者：
S. Hahn;Hong;H. Kang;E. Kang
自1983年至1998年，应用吻合神经血管的拇趾游离皮瓣再造手指16例。14例成功，2例失败。作者在术后平均约38个月对这些病例进行了审查。捏力是51%的未受影响的正常手，两点歧视是7.6毫米。移植骨的平均吸收是13%的宽度和9%的长度。无植骨断裂、骨不连、牙髓移位等并发症。该手术为功能性捏夹和抓握提供了长度、稳定性和足够的灵敏度。拇指上的环绕皮瓣的感觉返回通常大于对侧足相同区域的感觉返回。供区的环绕皮瓣是可以接受的，无论是美学和功能，并允许穿露趾鞋的年轻女性。对于掌指关节或掌指关节远端截肢的病例，以大脚趾为蒂的皮瓣重建手指可获得良好的外观和功能效果。此外，对于手指撕脱伤和肿瘤切除后软组织缺损的重建，此手术也是一个很好的选择。
From 1983 to 1998, 16 cases of finger reconstruction with a free neurovascular wrap-around flap from the big toe were treated. Fourteen cases were successful, and two cases failed. The authors reviewed these cases on the average of about 38 months after surgery. Pinch power was 51 percent of the unaffected normal hand, and two-point discrimination was 7.6 mm. The mean resorption of the grafted bone was 13 percent in width and 9 percent in length. There were no complications such as fracture of the grafted bone, nonunion, and pulp dislodgement. This procedure provided length, stability, and adequate sensibility for a functional pinch and grasp. Sensory return to the wrap-around flap on the thumb was often greater than for the same area on the opposite foot. The donor site of the wrap-around flap was acceptable, both aesthetically and functionally, and allowed the wearing of open-toed shoes by young women. Finger reconstruction with a wrap-around flap from the big toe yielded excellent cosmetic and functional results in cases involving amputation at the level of the metacarpophalangealjoints or distal to it. In addition, this procedure was an excellent choice for treatment in cases involving avulsion injuries of the fingers and reconstruction of soft-tissue defects after tumor excision.