中国临床解剖学杂志 ›› 2013, Vol. 31 ›› Issue (1): 42-46.

• 应用解剖 • 上一篇    下一篇

两种移植第2、3趾再造指甲体增长术的解剖学研究

王宝石1, 孙丽颖2, 田光磊2, 田宇1, 罗键1, 于晋辉1, 王清涛1, 王新民1   

  1. 1.秦皇岛市第一医院手外科,  河北   秦皇岛    066000; 2.北京积水潭医院手外科,  北京   100035
  • 收稿日期:2012-10-24 发布日期:2013-01-29
  • 通讯作者: 孙丽颖,博士,Tel:(010)58516688-6122, E-mail:slydaisy @139.com E-mail:wangbs485@tom.com
  • 作者简介:王宝石(1963-),男,副主任医师,研究方向:手部损伤修复,Tel:(035)5908579

Anatomic study of treatment of short nail of fingers reconstructed by  2nd, 3rd toe transplantation with eponychial flap and resection

WANG Bao-shi1, TIAN Yu1, LUO Jian1, YU jin-hui1, WANG Qin-tao1, WANG Xin-ming1,  SUN Li-ying2,  TIAN Guang-lei2   

  1. 1.Department of Hand Surgery, The First Hospital of Qinhuangdao, Qinhuangdao, 066000, China; 2.Department of Hand Surgery, Beijing Jishuitan Hospital, Beijing 100035, China
  • Received:2012-10-24 Published:2013-01-29

摘要:

目的 估算甲上皮瓣退缩移位术、近侧甲壁远端切除术于移植第2、3趾再造指的应用结果。  方法    测量40名男女成人正常双手拇、示、中、环、小指及双足第2、3趾甲体的宽度和长度。计算指、趾甲体的长度差、宽长比值及同宽长比值长度差。以长度差、同宽长比值长度差为标准,对文献所记述的两种手术于移植第2、3趾再造指的应用结果进行了评判。  结果 第2、3趾甲体分别较小、环、中、示、拇指短3.7~4.5 mm、4.8~5.5 mm、5.6~6.3 mm、5.9~6.8 mm、6.5~8.0 mm;第2、3趾甲体与各指甲体宽长比值相同时,分别较小、环、中、示、拇指短4.7~6.6 mm、3.7~4.7 mm、3.6~4.6 mm、4.4~5.6 mm、3.0~ 4.5 mm。文献所记上述手术于移植第2趾再造指的甲长增幅最多不过3 mm,较拇、示、中指还有3 mm以上的短缺,宽长比值也不能达到原指水平。  结论 甲上皮瓣退缩移位、近侧甲壁远端切除术于移植第2、3趾再造拇、示、中指的外观结果,难说是令人满意的。

关键词: 短甲畸形, 甲上皮瓣退缩移位术, 近侧甲襞远端切除术, 移植趾再造指

Abstract:

Objective To estimate the results of the treatment of short nail of fingers reconstructed by the 2nd , 3rd toe transplantation with the eponychial flap and eponychial resection.    Methods    The length and width of nail body were measured on 400 fingers, 160 2nd and 160 3rd toes of 40 normal adult persons(20 male, 20 female). The difference of the lengths between fingernail and toenail bodies, the width-to-length ratio of fingernail and toenail bodies and the difference of the length between fingernail and toenail bodies with the same width-to-length ratio were calculated, respectively. The results of the treatment of short nail of fingers reconstructed by the 2nd , 3rd toe transplantation with the eponychial flap and eponychial resection , which were reported previously by others, were evaluated again, taking consideration of the difference of the length between fingernail and toenail bodies, the difference of the length of fingernail and toenail bodies with the same width-to-length ratio.   Results    The length of the 2nd and 3rd toenail bodies was 3.7~4.5 mm, 4.8~5.5 mm, 5.6~6.3 mm, 5.9~6.8 mm, 6.5~8 mm shorter than the length of the little, ring, middle, index, thumb fingernail bodies, respectively Under the circumstances of the same width-to-length ratio, the length of the 2nd and 3rd toenail bodies was 4.7~6.6 mm, 3.7~4.7 mm, 3.6~4.6 mm, 4.4~5.6 mm, 3.0~4.5 mm shorter than the lengths of little, ring, middle, index and thumb fingernail body, respectively. The maximum increasing length of the transplanted 2nd and 3rd toenail bodies were 3mm postoperatively,which was less than half of the difference of the length between the toenail and thumb, index, middle fingernail bodies. The width-to-length ratio of the toenail body was not the same as that of the fingernail body as well.  Conclusions   It is still inconclusive that eponychial flap, eponchial resection were satisfying when they were applied to the thumb, index and middle fingers reconstructed by the 2nd and 3rd toe transplantation.

Key words: Short nail, Eponychial flap, Eponychial resection, Finger reconstructed by toe

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