15例游离足趾再造手指失败原因的分析及改进方法

目的 对15例游离足趾拇手指再造失败的原因进行分析并提出改进的方法。方法 1988年5月至2000年3月，利用游离足趾移植再造拇、手指351例。对其中15例拇、手指再造失败者进行了分析。结果 15例移植的均为第二足趾。足趾组织中第一跖背、跖底动脉吻合处及吻合后发出分支的形式和发至第二足趾趾动脉的管径细小是引起手术失败的主要原因(9／15)。结论 术中保留第二套供血系统，是解决第一跖背动脉和受动脉常规吻合后引起“顽固性痉挛”的最佳方法。

Analysis and improved methods for the failure of finger reconstruction using free toe:report of 15 cases

Objective To analyze the resulting failure of free toe transplantation for the fingers and thumb reconstruction in 15 cases and to put forward the improved methods. Methods From May 1988 to March 2000, 351 thumbs and fingers reconstruction with free toes were done. Among them, 15 cases with failure result were investigated. Results The second toe transfer was done in all the 15 cases. The major failure-causing reason was as follows: the anastomosis of the first dorsal metatarsal artery and the plantar artery, the branch form after the anastomosis , and the fine diameter of the artery supplying to the second toe (9/15). Conclusion Preservation of the second set artery-supplying system is an ideal method resolving the obstinate spasm after the anastomosis of the first dorsalis pedis artery and its recipient artery.