背景:指尖重建的目标是实现足够的软组织覆盖和功能的指甲板,并保持感觉,本体感受,和宇宙。目的:我们提出了一种复合组织移植物和掌侧V-Y推进皮瓣,用于重建指尖的创伤性截肢,这提供了下甲和掌垫的最佳保存,以防止钩钉。历史上,对于有较大缺陷的成年人,不建议使用复合指尖移植物。方法:截肢甲床,下甲,和指尖的10×20毫米段被用作复合移植物,用于重建成人的甲床。对于完整的软组织重建,必须增加掌侧V-Y前移皮瓣来重建指尖。结果:重建导致指甲板粘连,没有明显的指甲畸形和功能性和感觉的指尖。结论:截肢指尖的成分包括无菌基质,下甲,和指尖的一部分可以用于复合移植物中,以在成人中产生令人满意的功能和美容效果。
Background: The goals of fingertip reconstruction are to achieve adequate soft-tissue coverage and a functional nail plate and to maintain sensation, proprioception, and cosmesis. Objective: We present a composite tissue graft and volar V-Y advancement flap for reconstruction of a traumatic amputation of a fingertip, which provided optimal preservation of the hyponychium and the volar pad for prevention of a hook nail. Historically, composite fingertip grafts have not been recommended for adults with large defects. Methods: The amputated nail bed, hyponychium, and a 10 × 20-mm segment of the fingertip were utilized as a composite graft for reconstruction of the nail bed in an adult. The addition of a volar V-Y advancement flap to reconstruct the fingertip was necessary for complete soft-tissue reconstruction. Results: The reconstruction resulted in nail plate adhesion without significant nail deformity and a functional and sensate fingertip. Conclusion: Components of amputated fingertips including the sterile matrix, hyponychium, and part of the fingertip can be utilized in a composite graft to yield satisfactory functional and cosmetic results in adults.