Release of Finger Flexion Contracture with a Glabrous Free Tissue Transfer

屈曲攣縮的手指是手部外傷後極其不便的一種後遺症，攣縮的手指常會影響到其他未受傷手指的功能，在某些嚴重的手指攣縮甚至會導致關節的疼痛。這些嚴重的手指攣縮畸形往往合併皮膚軟組織的短缺，通常無法以z-plasty來延長疤痕；在將攣縮的手指以手術鬆開之後，又沒有適合的局部皮瓣可供轉移來覆蓋外露的肌腱或神經血管；這篇文章將說明以腳趾趾腹皮瓣及腳掌內側皮瓣來重建攣縮鬆弛術後的手指，兩個個案將在文中被詳述。在這篇文章裡，將會探討腳趾趾腹皮瓣及腳掌內側皮瓣的使用時機。這兩種皮瓣同樣提供一種無毛的皮膚組織(glabrous skin)，這種皮膚組織的特色是耐磨，穩定，而且感覺良好。這兩種皮瓣也同樣提供適當的大小可來重建攣縮鬆弛術後的手指。當手指攣縮同時牽涉到指尖也是攣縮畸形，這種手術時將會一併重建指尖指腹的缺損，故會採用以腳趾趾腹皮瓣來重建攣縮鬆弛術後的手指。如果手指攣縮並未涉及指尖畸形，能以腳掌內側皮瓣來重建，將可達到手指重建所希求的耐磨，穩定，好感覺。

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並列摘要

Flexion contracture of a finger is an inconvenient morbidity, which may interfere the function of other digits in a hand and occasionally induce joint pain in some strict cases. When the contracture is severe with shortage of skin, the scar cannot be lengthened with z-plasties alone, and there is no available local flap for covering the exposed tendon and neurovascular bundles, flaps from toe and medial plantar foot were introduced for reconstruction. Two cases were reported in this article. Indications for the hemipulp flap and the medialis pedis flap transfers are elaborated. Both flaps provide a glabrous skin, which is characterized as durability, stability and sensibility. The flap dimensions are appropriate for finger reconstruction after release of contracture. For fingers with fingertip involvement in flexion contracture, a hemipulp tissue transfer will be the best option. For those without a fingertip involvement, a medialis pedis flap can suffice the requirement of durability, stability and sensibility of a finger reconstruction.

並列關鍵字

flexion contracture ； glabrous skin ； hemipulp flap ； medialis pedis flap

國際替代計量

Release of Finger Flexion Contracture with a Glabrous Free Tissue Transfer

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