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目的 应用第二足趾胫侧趾固有动脉为蒂的两块游离皮瓣修复两个手指指端缺损,探讨手术方法和临床效果.方法 自2014年11月至2018年9月,对5例同时伴有两个手指指端缺损的患者,急诊采用游离第二足趾胫侧一蒂双瓣分别修复两指创面,均以第二足趾胫侧固有动脉为血管蒂,切取后两块皮瓣分别和伤指重建血液循环,供区采用小腿内侧全厚皮片植皮.结果 术后5例10指皮瓣均顺利存活,供受区伤口Ⅰ期愈合,无血管危象发生.随访时间为6～24个月,平均12个月,游离皮瓣外形、感觉及功能恢复良好,无需二次手术修薄,供区无明显瘢痕增生及挛缩,未出现不耐磨及疼痛等情况.结论 应用第二足趾胫侧切取两块游离皮瓣修复两个手指指端缺损,能较好地覆盖缺损创面,保证手指的外观、感觉及功能,同时可减少供区数量,减少损伤,是较理想的修复术式.“,”Objective To explore the surgical method and clinical efficacy of two free flaps pedicled with the tibial proper toe artery of the second toe for repair of the defects of two fingertips.Methods From November 2014 to September 2018,five patients with the defects of two fingertips were treated with one pedicle double flaps of the tibial side of the second toe in emergency.The proper artery of the tibial side of the second toe was used as the vascular pedicle.The blood circulation of the two flaps and the injured finger was reconstructed.The donor site was replanted with full thickness skin graft of the medial leg.Results All the 10 finger flaps survived uneventfully.The donor and recipient wounds achieved primary healing without vascular crisis.The postoperative follow-up ranged from 6 to 24 months with an average of 12 months.The appearance,sensation and function of the free flaps recovered well.No second operation was needed to thin the flaps.There were no obvious scar hyperplasia and contracture in the donor site,no abrasion resistance and pain.Conclusion The application of two free flaps from the tibial side of the second toe to repair fingertip defect of two fingers can cover the defect wound,ensure the appearance,sensation and function of the finger,reduce the number of donor sites and damage.It is an ideal repair method.