Ⅰ期趾甲延长术9例报告.pdfVIP

中国骨伤2∞8 年 1 月第 21 卷第 1 期 China J Orthop Trauma ， Jan.2∞8 ， Vo1.21 ， No.l • 47 • ·经验叉流· I 期趾甲延长术9 例报告 张功林 1 ，郭翻 1 ，章鸣 1 ，徐招跃 1 ，张灵芝 1 ，王顺柄 2 ，李俊 1 ，吴发林 2 ，郁辉 2 (l.温岭市骨伤科医院子外科中心，浙江 温岭 3175∞;2. 江苏大丰市同仁骨科医院) [摘要1 目的:总结 I 期在第 2 足趾游离移植再造拇(手)指中行趾甲延长的临床应用经验。方法:采用趾甲延长 方法对9 例(男 7 ，女 2 例)第 2 足趾移植再造拇(手)指的患者进行了趾甲延长术，其中拇指 8 例，食指 l 例。年龄 18町 46 岁，平均 25 岁。在再造指Jlé.甲根皮缘 5 mm 处，去除 1 块矩形皮肤，勿损伤皮下血管网。其高度 2mm，宽度与趾甲相 等，将 U 形皮瓣向近端柔和推剥并缝合。结果:1 例术后供区发生表浅感染，经换敷料逐渐愈合。再造的拇(手)指全部 成活，可延长趾甲 2-3 mm，改善了再造拇(手)指的外形，无指甲生长畸形发生。随访 7 个月4年(平均 13 个月) ，趾甲 外形较好。结论:在第 2 足趾祷离移植再造拇(手)指中应用 I 期趾甲延长术，使趾甲从短小向纵向延长，缩小手指甲与 足趾甲之间差异，能改善再造拇(手)指甲外形，且不影响再造指的活动功能，是一种简单有效的手术方法。 [关键词1 趾甲: 再造; 拇(手)指 One-stage t盹nailleng伽ening:a report of 9 cases ZHANG Gong-lin 食 ， GUO Ao ,ZHANG Míng ,XU zhω-yω， ZHANG Líng-zhí , WANG Shun-bíng ,LI Jun , WU Fa-lín , YU Hu í. *Department of Hand Surgery Center ,the Orthopaedícs and Trau- matology Hospítal ofWenlíng , Wenlíng 3175∞，Zhejíang， China ABSTRACT Objective:To summarize clínícal applícatíon of one -stage toenaillengtheníng ín free second toe transfer for reconstructíon of the thumb(finger). Methods:Níne patients(male 7 ,female 2)underwent thumb(finger)reconstructíon with second toe transfer were treated by one -stage toenaillengtheníng techníque. Eight were the thumb and 1 was the índex fin- ger. Patíents aged from 18 to 46 years ,wíth an average of 25 years. A rectangle skín was resected at 0.5 cm away from the eponychium ,whích was 0.2 cm high and as wide as the toenaíl. Then strípped U shape flap genÙY towards proxímal end and sutured it. Duríng the operation ,the ínjUlγof the subcutaneous vascular network should be avoided. Results: Superficíal ín- fectíon at donor area happened ín 1 case and was healed by changíng dressíngs. All the recons