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采用带血管蒂部分甲-骨-皮复合组织移植的手指再造:是时候关注供区了。

Finger reconstruction with vascularized partial osteo-onycho-cutaneous great toe transfer: It's time to address the donor site.

作者信息

Jhunjhunwala Nikhil, Dutta Amitabh, Siwas Gourav, Mangal Mahesh

机构信息

Department of Plastic, Cosmetic, Hand and Microsurgery, Sir Ganga Ram Hospital, Room No. 2325, 3rd Floor, SSRB Building, New Delhi, 110060, India.

Department of Anaesthesia, Sir Ganga Ram Hospital, New Delhi, 110060, India.

出版信息

J Hand Microsurg. 2024 Dec 19;17(2):100204. doi: 10.1016/j.jham.2024.100204. eCollection 2025 Mar.

Abstract

Free vascularized partial great toe is a composite tissue consisting of the osteo-onycho-cutaneous component with neurovascular pedicle and is used for reconstructing amputated fingers at different levels. The half-big-toe nail flap represents that while it provides a good match and functional results; it also conserves the donor foot by having all five toes intact. The aesthetic and functional aspects of the amputated thumbs and fingers can be worked upon and significantly improved. We feel that all amputated fingers or thumbs at different zones or levels of amputation can be functionally reconstructed using vascularized tissue from the partial great toe and PIP joint from the 2nd toe. This conservative yet decisive surgery option keeps donor site functional morbidity to the minimum. Only that surgery must still look up to and progress in improving aesthetic reflection and functional elements for the larger benefit of the patients.

摘要

游离带血管蒂部分拇趾是一种由带有神经血管蒂的骨-甲-皮成分组成的复合组织,用于重建不同平面的断指。半拇趾甲瓣意味着它不仅能提供良好的匹配度和功能效果,还能通过保留所有五个脚趾来保护供足。断指和断拇的美学和功能方面都可以得到改善并显著提升。我们认为,不同区域或截肢平面的所有断指或断拇都可以使用部分拇趾的带血管组织和第二趾的近端指间关节进行功能重建。这种保守而果断的手术选择能将供区功能并发症降至最低。只是手术仍必须着眼于并致力于改善美学效果和功能要素,以给患者带来更大益处。

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