Hirasé Y, Kojima T, Matsui M
Department of Plastic and Reconstructive Surgery, Jikei University School of Medicine, Tokyo, Japan.
Plast Reconstr Surg. 1997 Mar;99(3):774-84. doi: 10.1097/00006534-199703000-00026.
Microsurgical toe transfer is an established procedure for functional reconstruction of fingers. However, even if the functional loss is minimal, the fingertip defect is often a large problem for patients for not only functional reasons but also aesthetic reasons. In these patients, although the normal appearance of the fingertip is very important, total toe transfer is not acceptable because of resection of an entire toe. With this background, partial toe transfer techniques have greatly progressed. On the other hand, various types of innervated finger flaps also have been developed in hand surgery. Based on this progress, we developed the combined technique of innervated finger flaps in the hand and osteo-onychocutaneous flaps from the toe. This technique provides better aesthetic results in fingertip reconstruction, thus broadening the indications for vascularized nail grafts. We have now experienced 60 flaps in partial toe transfer. In this report, a review of 60 consecutive flaps is presented, and the indications, technique, and postoperative treatment are discussed.
显微外科足趾移植是一种成熟的手指功能重建手术。然而，即使功能丧失最小，指尖缺损对患者来说往往也是一个大问题，这不仅是出于功能原因，也是出于美观原因。在这些患者中，尽管指尖的正常外观非常重要，但由于要切除整个足趾，全足趾移植是不可接受的。在此背景下，部分足趾移植技术有了很大进展。另一方面，手外科也开发了各种类型的带神经血管蒂手指皮瓣。基于这一进展，我们开发了手部带神经血管蒂手指皮瓣与足部骨-甲-皮瓣联合技术。该技术在指尖重建中提供了更好的美学效果，从而拓宽了血管化指甲移植的适应证。我们目前已经进行了60例部分足趾移植皮瓣手术。在本报告中，对连续60例皮瓣进行了回顾，并讨论了适应证、技术和术后治疗。
