Objective To evaluate the treatment effect of hand reconstruction with bilateral multiple toe transplantation. Methods There are four schedules as follow applied in 102 cases: (1) bilateral second toes to thumb and index finger transplantation in 86 cases; (2) wrap-around flap to thumb and second toe on opposite side to index or middle finger transplantation in 11 cases; (3) wrap-around flap to thumb and bilateral second toes to index and middle fingers transplantation in 8 cases; (4) bilateral wrap-around flap to bilateral thumb and second toe to index finger transplantation in 1 case. Results All reconstructed finger survived in 102 cases except for partial wrap-around flap necrosis in one case and second toe in two cases. Sixty-two patients got more than one-year following up. Two points discrimination in reconstructed finger was between 8 to 14 mm in all cases. The reconstructed finger grew synchronously with toe among children. Thumb opposition function recovered in all cases except for one case. Donor site: no limp or hallux eversion observed in all cases. Conclusion There is less damage on foot and most hand function recovery using bilateral multiple toe transplantation to repair hand or multiple fingers defect.%目的 评价应用双侧多个足趾移植修复全手或多手指缺损的临床疗效.方法 临床应用102例,手术方法有4种:①利用双侧第二足趾移植再造拇、手指86例;②一侧甲瓣再造拇指,另一侧第二足趾再造手指11例;③一侧甲瓣与第二足趾再造拇指和示指,另一侧第二足趾移植再造中指8例;④双侧甲瓣与第二足趾移植再造双侧拇指与示指1例. 结果 102例中除1例部分甲瓣坏死,2例第二足趾坏死,其余全部成活.62例获得1年以上的随访.再造拇手指两点辨别觉达8～14mm.小儿移植手指生长与足趾同步.所有的随访病例中除1例不能作对掌对指功能外,余全部恢复.供区:所有病例无跛行,无外翻发生. 结论 对于多手指或全手缺损,应用双侧足部多个足趾再造手指,对足部供区外形和创伤较小,手部可获得最大功能恢复.
展开▼
