足趾移植多手指再造相关问题的探讨

摘要

Objective To study the relevant techniques of multi-finger reconstruction by toe-to-hand transfer and discuss the approaches to achieve better results. Methods A systemic review of 1 597 cases (1 974 fingers) of finger reconstruction by toe-to-hand transfer done during the period of January 1980 to February 2010 in our hospital was carried out. Among these, 354 cases (731 fingers) underwent multi-finger reconstruction (more than two fingers). They were analyzed retrospectively in respects of surgical indication,surgical methods, and postoperative functional recovery in order to seek the patterns and sum up the experience.Results Of the 731 fingers, 725 transplants survived. Only 6 transplants were lost. The survival rate was 99%. Surgical exploration was carried out in 29 cases due to vascular crisis. There were 35 cases that were follow-up for 6 months to 11 years. The appearance and functions of the reconstructed fingers were satisfactory.The patients could return to their jobs and were satisfied with the outcome. Conclusion Multi-finger defect greatly affects the appearance and function of the hand. An appropriate surgical reconstruction strategy should be chosen based on the condition of the hand, patient' s age and demand to restore a near normal hand.%目的 研究多个手指缺损应用足趾移植再造的相关技术,以提高其疗效.方法 从1980年1月至2010年2月,我院进行足趾移植拇手指再造共计1 597例1 974指,对其中2指以上的多指再造354例731指进行了系统的回顾性分析.从手术适应证的掌握、手术方法及术后功能恢复等方面寻找规律,总结经验.结果 术后731指存活725指,失败6指,成活率为99%.29例术后发生血管危象,进行了再次手术探查.35例获得6个月至11年的随访,均恢复了较好的外形和手功能,胜任各种工作,患者满意.结论 多手指的缺损对患手功能和外观影响较大,要根据患手条件、患者年龄和本人意愿,选择合适的再造方案,最大限度地为患者再造一个接近正常的手.