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目的总结足趾或甲瓣移植急诊再造小儿手指成活的临床经验,评估足趾或甲瓣移植急诊再造小儿手指的可行性。方法1996年3月-2008年8月采用足趾和甲瓣移植急诊再造小儿手指28例,单个指再造18例,2、3指单指再造10例。利用长蒂法第2足趾移植14例,短蒂法足趾移植6例;单纯甲瓣8例,带足背皮瓣的第2足趾2例。结果28例手术全部急诊完成,并均获得存活。2例术后发生血管危象,探查发现血栓形成,重新吻合血管后成活。3例供足植皮部分坏死经换药治疗瘢痕愈合。随访6个月～5a(平均28.4个月),所有再造拇手指血运丰富,感觉恢复良好,生长发育好。两点分辨觉8～12mm。对指对掌灵活,能够握笔写字,再造拇手指发育正常,外形满意。结论对于外伤性小儿拇手指缺损,采用足趾或甲瓣移植急诊再造,可以获得满意的再造效果。
OBJECTIVE: To summarize the clinical experience of transplanted emergency fingerprints in children with toe or popliteal nail transplantation and to evaluate the feasibility of transplanting children’s finger with toe or popliteal flap for emergency. Methods From March 1996 to August 2008, 28 children underwent emergency reconstruction with a toe and flutter flap. Eighteen patients underwent reconstruction with a single finger and 10 fingers with a single finger. In the long pedicure method, the second toe was transplanted in 14 cases and the short pedicled toe transplantation in 6 cases. There were 8 cases with simple floss flap and 2 cases with second dorsal foot flap. Results All the 28 surgeries were completed and all survived. 2 cases of vascular crisis occurred after surgery, exploration found thrombosis, re-meet the vascular survival. 3 cases of skin graft partial necrosis by dressing treatment of scar healing. All patients were followed up for 6 months to 5a (average 28.4 months). All the thumbs of the re-created thumbs had rich blood supply, good sensation and good growth and development. Two points of resolution 8 ~ 12mm. Finger on the palm flexible, able to hold the pen to write, reproduce the normal thumb thumb development, shape satisfactory. Conclusion For the traumatic children thumb thumb defect, the use of toe or flap transplanted emergency reconstruction, can be satisfied with the reconstruction effect.