Ⅰ期趾甲延长术9例报告
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作者Author单位AddressE-Mail
张功林 ZHANG Gong-lin 温岭市骨伤科医院手外科中心,浙江 温岭 317500 Department of Hand Surgery Center,the Orthopaedics and Traumatology Hospital of Wenling,Wenling 317500,Zhejiang,China 668zgl@163.com 
郭翱 GUO Ao 温岭市骨伤科医院手外科中心,浙江 温岭 317500 Department of Hand Surgery Center,the Orthopaedics and Traumatology Hospital of Wenling,Wenling 317500,Zhejiang,China  
章鸣 ZHANG Ming 温岭市骨伤科医院手外科中心,浙江 温岭 317500 Department of Hand Surgery Center,the Orthopaedics and Traumatology Hospital of Wenling,Wenling 317500,Zhejiang,China  
徐招跃 XU Zhao-yao 温岭市骨伤科医院手外科中心,浙江 温岭 317500 Department of Hand Surgery Center,the Orthopaedics and Traumatology Hospital of Wenling,Wenling 317500,Zhejiang,China  
张灵芝 ZHANG Ling-zhi 温岭市骨伤科医院手外科中心,浙江 温岭 317500 Department of Hand Surgery Center,the Orthopaedics and Traumatology Hospital of Wenling,Wenling 317500,Zhejiang,China  
王顺柄 WANG Shun-bing 江苏大丰市同仁骨科医院  
李俊 LI Jun 温岭市骨伤科医院手外科中心,浙江 温岭 317500 Department of Hand Surgery Center,the Orthopaedics and Traumatology Hospital of Wenling,Wenling 317500,Zhejiang,China  
吴发林 WU Fa-lin 江苏大丰市同仁骨科医院  
郁辉 YU Hui 江苏大丰市同仁骨科医院  
期刊信息:《中国骨伤》2008年,第21卷,第1期,第47-48页
DOI:doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz
基金项目:
中文摘要:

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1例。年龄18~ 46岁,平均25岁。在再造指距甲根皮缘5 mm处,去除1块矩形皮肤,勿损伤皮下血管网。其高度2 mm,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~2年(平均13个月),趾甲外形较好。

结论:在第2足趾游离移植再造拇(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】趾甲  再造  拇(手)指
 
One-stage toenail lengthening:a report of 9 cases
ABSTRACT  

Objective: To summarize clinical application of one-stage toenail lengthening in free second toe transfer for reconstruction of the thumb(finger).

Methods: Nine patients(male 7,female 2)underwent thumb(finger)reconstruction with second toe transfer were treated by one-stage toenail lengthening technique. Eight were the thumb and 1 was the index finger. Patients aged from 18 to 46 years,with an average of 25 years. A rectangle skin was resected at 0.5 cm away from the eponychium,which was 0.2 cm high and as wide as the toenail. Then stripped U shape flap gently towards proximal end and sutured it. During the operation,the injury of the subcutaneous vascular network should be avoided.

Results: Superficial infection at donor area happened in 1 case and was healed by changing dressings. All the reconstruction thumbs(fingers)had survived completely. 2 to 3 mm extending of toenail length was obtained and the appearance of thumb(finger)was improved. There was no growth deformation of toenail. After 7 to 24 months follow up(the average time 13 months),the appearance of t- he nail was good.

Conclusion: One-stage toenail lengthening in free second toe transfer for reconstruction of the thumb(finger),which can obtain a satisfactory appearance of the nail and have no influence on the motion of the reconstruction thumb(finger),is a simple and an effective operative procedure.
KEY WORDS  Toenail  Reconstruction  Thumb(Finger)
 
引用本文,请按以下格式著录参考文献:
中文格式:张功林,郭翱,章鸣,徐招跃,张灵芝,王顺柄,李俊,吴发林,郁辉.Ⅰ期趾甲延长术9例报告[J].中国骨伤,2008,21(1):47~48
英文格式:ZHANG Gong-lin,GUO Ao,ZHANG Ming,XU Zhao-yao,ZHANG Ling-zhi,WANG Shun-bing,LI Jun,WU Fa-lin,YU Hui.One-stage toenail lengthening:a report of 9 cases[J].zhongguo gu shang / China J Orthop Trauma ,2008,21(1):47~48
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