Sastre N, Caravantes M I, Mayoral-Garcia C
Plastic Surgery Service, Hospital General de Mexico, Mexico D.F, Mexico.
J Reconstr Microsurg. 1996 Oct;12(7):431-7. doi: 10.1055/s-2007-1006615.
A case of a 25-year-old, male farm worker with a history of traumatic amputation of the right first ray, complete absence of the first metacarpal, and every phalanx of the second finger is presented. A two-stage surgical reconstruction was planned, initially, with transfer of the second metacarpal to the trapezium, creating the first web space which was covered with skin from a reverse radial forearm flap. The second stage included transfer of the right big toe to the hand with anastomoses of the first dorsal metatarsal artery to the radial artery (end-to-end) and the veins to the radial vena comitans and cephalic vein in the flap (reverse flow). Functional and cosmetic results were excellent. The physiologic considerations of reverse flow are discussed.
本文介绍了一例25岁男性农场工人，其有右手第一列创伤性截肢病史，第一掌骨完全缺失，第二指各指骨也缺失。计划进行两阶段手术重建，首先将第二掌骨转移至大多角骨，形成第一蹼间隙，并用桡侧前臂逆行皮瓣覆盖。第二阶段包括将右拇趾转移至手部，将第一跖背动脉与桡动脉端端吻合，将皮瓣中的静脉与桡侧伴行静脉和头静脉进行吻合（逆向血流）。功能和美容效果极佳。文中讨论了逆向血流的生理考量。
