改良第2跖趾关节移植修复拇手指掌指关节背侧缺损

摘要

Objective To explore a new improved technique and its clinical effect on the treatment of composite tissue dorsal defects in the metacarpophalangeal joint by transplantation of the second metatarsophalangeal joint. Methods From June 2006 to June 2013, According to the damage characteristic of metacarpophalangeal joint, twenty-five joints of 24 cases were repaired using the improved second metatarsophalangeal joint composite flaps, and the cases were follow-up on a regular basis and functional assessment. Results The composite flaps in 24 cases survived, incision healed, all graft skin survived well. The patients were followed up for 6 to 48 months, and no joint degeneration in X-ray manifestation occured and the recovery of joint function is satisfactory. According to the function evaluation standard of reconstraction of thrumb and finger issued by Hand Surgery Society Chinese Medical Association, the excellent and good rate was 92.0%. There was no influence on donor foot function and appearance. Conclusion Although there is operation risk, but after the rapairing, it can maximize the recovery of appearance and function. So transplantation of the second metatarsophalangeal joint is a kind of technique and were popularization to treat composite tissue dorsal defects in the metacarpophalangeal joint.%目的：探讨应用改良第2跖趾关节背侧复合组织瓣移植修复掌指关节背侧缺损的方法及临床疗效。方法2006年6月—2013年6月，采用改良的第2跖趾关节背侧复合组织瓣修复24例25处掌指关节背侧缺损。术后定期随访并进行功能评定。结果本组25处复合组织瓣全部成活，切口均一期愈合，供足植皮成活良好。全部病例得到随访，随访时间6~48个月，X线片提示骨骼愈合，重建掌指关节均获得较好的功能恢复。按中华医学会手外科分会拇手指再造功能评定试用标准评定优良率为92.0%。供足外形及功能无明显影响。结论采用改良第2跖趾关节背侧复合组织瓣移植修复拇手指掌指关节背侧缺损，虽然手术风险较大，但能最大限度地修复关节外形、恢复功能，值得临床推广应用。