Iglesias M, Butron P, Serrano A
Department of Plastic Surgery, Instituto Nacional de la Nutrición Salvador Zubirán, México D.F.
J Hand Surg Am. 1995 Sep;20(5):731-6. doi: 10.1016/S0363-5023(05)80422-8.
Twelve amputated thumbs were reconstructed with a neurovascular cutaneous flap from the great toe and an osteotendinous flap from the second toe. Both transfers were dependent on a single vascular pedicle. One of the 12 reconstructions failed. In the remaining 11, the mobility of the metacarpophalangeal joint ranged from 10 degrees to 50 degrees, and that of the interphalangeal joint from 10 degrees to 30 degrees. Opposition and key pinch were restored, and the shape and volume were similar to those of the normal thumb. Likewise, the great toe was preserved, and all patients had a normal gait. This technique preserves the epiphyses for future growth in children and maintains the aesthetic appearance of the foot, but it has the disadvantage of involving a lengthy surgical procedure with a 17% rate of major complications.
采用取自拇趾的神经血管皮瓣和取自第二趾的骨腱瓣对12例断离拇指进行了再造。两种组织瓣的移植均依赖单一血管蒂。12例再造中有1例失败。其余11例中，掌指关节活动度为10度至50度，指间关节活动度为10度至30度。对掌和捏物功能得以恢复，外形和体积与正常拇指相似。同样，拇趾得以保留，所有患者步态正常。该技术可保留骨骺以供儿童日后生长，并保持足部美观，但缺点是手术过程冗长，严重并发症发生率为17%。
