Foucher G
Clinique du Parc, Strasbourg.
Ann Chir Plast Esthet. 1996 Apr;41(2):197-207.
Reconstruction of the thumb after traumatic mutilation constitutes a delicate indication in order to select the technique most adapted to the patient's functional needs and esthetic desires. Pollicizations of healthy fingers are now used less frequently, except in the clinical context of very proximal amputations, but amputations of mutilated fingers remain a frequent indication. Progressive lengthening was associated with a high complication rate, although these complications have remained minimal. Osteoplastic reconstruction is still occasionally indicated in its modern version of composite flap. Finally, toe transfers now have a large place in young subjects, "tailored" transfer is preferred to first or second toe transfer in the case of isolated amputation of the thumb, due to its esthetic advantages.
创伤性拇指离断后的重建是一项精细的手术指征,需要选择最适合患者功能需求和美学期望的技术。除了在非常近端截肢的临床情况下,健康手指的拇指化现在使用频率较低,但残缺手指的截肢仍然是常见的指征。渐进性延长术的并发症发生率较高,尽管这些并发症一直很少。骨成形重建术在其现代复合皮瓣版本中仍偶尔被采用。最后,足趾移植在年轻患者中现在占据重要地位,在拇指孤立截肢的情况下,由于其美学优势,“定制”移植比第一或第二足趾移植更受青睐。