两种移植第2、3趾再造指甲体增长术的解剖学研究

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。

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

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.