Wei F C, Chen H C, Chuang C C, Noordhoff M S
Department of Plastic Surgery, Chang Gung Memorial Hospital, Taipei, Taiwan.
Plast Reconstr Surg. 1988 Mar;81(3):366-77. doi: 10.1097/00006534-198803000-00009.
Our experience with simultaneous transfer of two or more toe units to the same hand where multiple digits were missing is presented. Forty-six toes from 38 feet were transferred to reconstruct 19 hands in 19 patients. The transfers consisted of 7 combined second and third toe units and 32 single toes. Three patients had a primary and 16 patients had a secondary reconstruction. There was one complete and one partial failure. The two-point discrimination ranged from 6 mm to protective sensation. Total active movement averaged 57 degrees in the thumb and 127, 93, 71, and 68 degrees, respectively, in the fingers reconstructed at middle phalanx, proximal phalanx, metacarpophalangeal joint, and metacarpal head. Pulp-to-pulp pinch averaged 2.4 kg in patients who had thumbs reconstructed and averaged 3.0 kg in patients who had normal thumbs. There was no cold intolerance, and no significantly disabled foot occurred except one with scissoring deformity. Simultaneous multiple toe transfer in hand reconstruction is feasible without increased complications both in primary and secondary wound conditions. It is time-effective and cost-effective.
本文介绍了我们在将两个或更多趾单元同时转移到同一只缺失多个手指的手上的经验。从38只脚上取下46个趾，用于重建19例患者的19只手。转移包括7个第二和第三趾联合单元以及32个单趾。3例患者进行了一期重建，16例患者进行了二期重建。有1例完全失败和1例部分失败。两点辨别觉范围为6毫米至保护性感觉。拇指的总主动活动平均为57度，在中节指骨、近节指骨、掌指关节和掌骨头重建的手指中，分别平均为127度、93度、71度和68度。重建拇指的患者的指腹对指腹捏力平均为2.4千克，拇指正常的患者平均为3.0千克。没有冷不耐受情况，除1例有剪刀样畸形外，没有出现明显残疾的足部。在手重建中同时进行多趾转移在一期和二期伤口情况下都是可行的，且不会增加并发症。它具有时间效益和成本效益。
