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首页> 外文期刊>Journal of Hand Surgery. American Volume >Neurovascular Island Flap for Pulp and Nail Augmentation in Thumb Duplication Reconstruction: A Surgical Method With Long-Term Follow-Up
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Neurovascular Island Flap for Pulp and Nail Augmentation in Thumb Duplication Reconstruction: A Surgical Method With Long-Term Follow-Up

机译：拇指复制重建中的纸浆和钉钉的神经血管岛瓣：长期随访的手术方法

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Purpose Pulp and nail atrophy and asymmetry are commonly seen in thumb duplication. In hypoplasia of both digits, conventional reconstruction or Bilhaut-Cloquet procedure and its modifications may not be possible or may lead to a poor cosmetic outcome. The purpose of the study was to review a reconstruction technique with a neurovascular island flap developed to improve the aesthetic and functional results of treatment. Methods Fourteen patients with thumb duplication aged 8 to 18 months were operated between 2002 and 2013 in our center. All patients had significant hypoplasia and asymmetry of the pulp and nail of the digit planned to be retained. A neurovascular island flap including part of the pulp tissue, nail bed, with or without the associated phalangeal bone, was raised from the planned ablated digit base on its single neurovascular bundle. The nail bed, nail fold, and pulp tissue from the 2 digits were apposed with fine sutures under magnification. All patients were followed to monitor the aesthetic, functional, and radiological outcome. Results The mean follow-up period was 7 years, 11 months. Thirteen patients underwent the flap procedure and all flaps survived. In 1 patient, the flap procedure was aborted because the vascular pedicle was not well formed. The nail width and pulp circumference were restored to a similar size as the contralateral thumb. Conclusions In selected cases of thumb duplication with significant pulp hypoplasia and nail asymmetry, the neurovascular island flap is a safe and effective means to restore size and symmetry. Copyright (C) 2021 by the American Society for Surgery of the Hand. All rights reserved.
机译：目的：重复拇指中常见牙髓和指甲萎缩及不对称。在双指发育不全的情况下，常规重建或Bilhaut-Cloquet手术及其修改可能不可行，或可能导致较差的美容效果。本研究的目的是回顾一种神经血管岛状皮瓣重建技术，以改善治疗的美学和功能效果。方法2002年至2013年，对14例8～18个月的拇指重复畸形患者进行手术治疗。所有患者都有明显的发育不全和计划保留的手指髓甲不对称。一个神经血管岛状皮瓣，包括部分牙髓组织、甲床，带或不带相关的指骨，从计划的消融趾基部以单个神经血管束为基础提出。放大镜下，用细缝线缝合两指的甲床、甲襞和髓组织。对所有患者进行随访，以监测其美学、功能和放射学结果。结果平均随访7年11个月。13名患者接受了皮瓣手术，所有皮瓣均存活。1例患者因血管蒂成形不良，皮瓣手术流产。指甲宽度和牙髓周长恢复到与对侧拇指相似的大小。结论在选择的具有明显牙髓发育不良和指甲不对称的拇指重复畸形病例中，神经血管岛状皮瓣是一种安全有效的恢复大小和对称性的方法。版权所有（C）2021美国外科学会的手。版权所有。

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