Free Toe Pulp Transfer for Digital Reconstruction

使用自由趾間腹皮瓣作手指腹部重建

婉勝發(Sheng-Fa Yao) ； 鄭勝峰(Seng-Feng Jeng) ； 陳添興(Tien-Hsing Chen) ； 劉奕添(Yi-Tein Liu) ； 葉明中(Ming-Chung Yeh) ； 賴瑞斌(Jui-Pin Lai) ； 黃慧芬(Faye Huang) ； 郭耀仁(Yur-Ren Kuo)

《中華民國整形外科醫學會雜誌》 11卷3期 (2002/09) Pp. 185-192

https://doi.org/10.7096/JPSA.200209.0185

摘要

手指腹部缺損重建之問題，不只在保有手指原有長度，提供一個能抵抗磨擦的軟組織墊，更重要的是要能回復原來的感覺。解剖上，腳趾間腹和手指腹的組織結構相近。從1992年到2001年，我們使用自由趾間腹皮瓣來重建14個病人15個手指腹部缺損，包括十一個拇指一個食指兩個中指和一個無名指。 手指腹部缺損面積從2.5×2cm^2到4.5×2.5cm^2不等。平均追蹤28個月。全部病患於取皮瓣處皆補皮。全部皮瓣皆存活。有兩個病患於補皮處有部分皮膚缺損．但只須自然癒合。沒有走路困難的問題。只有一個病患抱怨皮瓣太大。另有兩個病患覺得對冷耐受性較差。兩個病患覺得感覺異常。測病患重建處的兩點間感覺範圍從6mm到I5mm。平均9.9mm。我們相信使用自由趾間腹皮瓣來作手指腹部缺損重建，不論美觀或功能上，都能得到滿意的結果。

並列摘要

The problem of loss pulp substance of the fingers during an unanticipated event such as trauma, represents not only the deprivation of tactile perception, but also the loss of a solid, well-cushioned covering. The ultimate goals for the reconstruction of finger pulp are to maintain the original digital length, provide adequate soft tissue padding and to obtain near-normal sensations. Anatomically and functional speaking, the most suitable source for finger pulp reconstruction will be the toe pulp.
A total of 15 free toe pulp transfers were done for finger pulp reconstruction between 1992 and 2001 which included 11 thumbs, 1 index finger, 2 middle fingers, and 1 ring finger. The pulp size varied from 2.5×2 cm^2 to 4.5×2.5 cm^2. All patients were followed-up for an average of 28 months (range: 10 to 64 months). All the toe donor sites were closed with split thickness skin grafts. The survival rate of the transferred toe pulp flap was 100% in all of the 15 flaps. Partial loss of skin graft in the donor site was noted in 2 of the 15 flaps, but secondary healing was accomplished later. No discomfort was identified during maneuvers such as walking. Satisfactory functional and cosmetic results were reported in 13 of the 15 flaps. One patient had complained about the bulkiness of the transferred pulp flap. Cold intolerance of the injured digit was noted in 2 patients and two complains were about hypoesthesia of the transferred pulps. S2-PD ranged from 6 to 15 mm with an average of 9.9 mm. We believe that the free toe pulp transfer is an excellent option for the finger pulp reconstruction with minimal donor site morbidity.

並列關鍵字

free toe pulp transfer ； finger pulp reconstruction