Valenti P
Institut de la main, 6 square Jouvenet, Paris, France.
Chir Main. 2010 Dec;29 Suppl 1:S184-92. doi: 10.1016/j.main.2010.09.020. Epub 2010 Oct 15.
The vascularized bone proved its capacity to be healed, without resorption even in sclerotic or infected tissue. Reconstruction of the distal part of the finger is often difficult for a pedicle transplant and a conventional bone transplant disappears. So the free vascularized bone transfer (FVBT) is indicated in distal post-traumatic finger amputations. According to the loss of substance to be reconstructed, the vascularised bone is harvested with some pulp, the nail complex or the cartilage of growth for a child. We report our experience of the technique of wrap around modified, of partial transfers of the second toe and the technique of reconstruction of claw nail deformity. The vascularised transfer of the cartilage of growth at the child is essential to allow the growth of the transferred phalanx. The indications are rare, however the children, the musicians or the patients who require fine pinch can benefit from this type of sophisticated reconstructive microsurgery.
带血管蒂的骨显示出其愈合能力，即使在硬化或感染组织中也不会发生吸收。手指远端的重建对于带蒂移植来说往往很困难，而且传统的骨移植会吸收消失。因此，游离带血管蒂骨移植（FVBT）适用于创伤后手指远端截肢。根据待重建组织的缺损情况，带血管蒂骨可连同一些指腹、甲复合体或儿童的生长软骨一并切取。我们报告了改良环绕技术、第二趾部分移植技术以及爪形指甲畸形重建技术的经验。儿童生长软骨的带血管蒂移植对于所移植指骨的生长至关重要。适应证很少见，然而儿童、音乐家或需要精细捏持功能的患者可受益于这类复杂的显微重建手术。
