Brunelli F, Brunelli G R, Perrotta R
Institut Français de la Main, Paris, France.
Ann Chir Main Memb Super. 1992;11(5):411-5. doi: 10.1016/s0753-9053(05)80279-0.
The hand of a three-year old girl was reconstructed by means of a bilateral second toe transplantation following traumatic amputation of all five digits. In a second operation, aimed at reconstructing the index finger, the nail apparatus of the big toe was transferred to the thumb as an "island flap" based on a pedicle from the second toe. The thumb was subsequently lengthened enabling a three-fingered hand to be obtained with only minimal functional impairment of the feet. The authors suggest an original technique allowing transfer of the second toe and of the big toe nail in only one operative stage. The technique of leaving the pedicle exteriorized during transplantation (autonomization) facilitates positioning of the nail onto the recipient site and eliminates subsequent problems of commissural retraction.
一名三岁女童因所有五根手指外伤性截肢，通过双侧第二趾移植对手部进行了重建。在旨在重建食指的第二次手术中，将拇趾的甲床作为基于第二趾蒂的“岛状皮瓣”转移至拇指。随后对拇指进行延长，从而在足部仅产生最小功能障碍的情况下获得了一只三指手。作者提出了一种仅在一个手术阶段就能转移第二趾和拇趾甲的原创技术。移植过程中将蒂留在体外（自主化）的技术便于将甲定位到受区，并消除了后续的连合退缩问题。
