Reconstruction of thumb and finger defects

The thumb function accounts for 40% of the full-hand function. After missing, it will seriously affect the pinch, grip, grasp, and squat functions of the hand. On the other hand, the thumb is alive, and the other 4 systems are all missing or partially missing, and the same obstacles exist. Therefore, it is necessary to reconstruct the thumb or other 4 fingers. At present, there are many methods for the reconstruction of the thumb and fingers, and various methods have certain advantages and disadvantages. Not all fingers are missing, and reconstruction is required. It should be considered according to the length of the residual finger, the condition of the stump, the condition of the toe and the foot, the age of the patient, the general condition, the patient's requirements, occupation and work needs. Reconstruction of the thumb is currently recognized as a better method for free toe transplantation and reconstruction of the thumb flap. Treatment of diseases: hand trauma fractures Indication Suitable for one thumb and one finger and one thumb and two fingers. Preoperative preparation 1. Establish a good relationship between nurses and patients. Respect each other and trust each other. 2, adjustment support system patients often have some worries after hospitalization, such as worry about the economic burden, worry about work problems, worry about how others see their own re-creation of fingers and other caregivers should try to get the encouragement and support of family members and colleagues to receive treatment. 3. Creating a good environment for a good medical environment is important for normal people. It is more important for patients. A quiet and clean environment is conducive to calming the patient's mood. Watching TV, listening to music, walking outdoors and other activities can distract the patient's attention and reduce the patient's psychological burden. 4, the use of cognitive therapy cognitive therapy is through the interaction between the nurse and the patient through the communication to make the patient understand the meaning of the conversation related to the common sense of the patient to answer the various concerns of the patient to re-recognize it to let go of the mind Various burdens. Surgical procedure One thumb and one finger reconstruction: Cut the second toe of the two feet and reconstruct the incision design of the thumb and fingers. The bilateral second toes, which were pedicled with the dorsal artery of the foot and the saphenous vein, were routinely cut. The broken pedicle is moved to the receiving area. The receiving area is prepared according to the routine and accepts the toe transplant. Intraosseous fixation is performed in order to repair the finger extension, flexor tendon and repair the finger nerve. The second dorsal metacarpal artery and the saphenous vein transplanted to the thumb are end-to-end anastomosis with the radial artery and the cephalic vein through the subcutaneous tunnel; the dorsal artery of the toe and the saphenous vein transplanted to the index finger are subcutaneously tunneled. The dorsal side of the "Tiger's mouth" was anastomosed with the branch of the dorsal artery of the reconstructed thumb and the branch of the saphenous vein. The blood vessels were sutured in parallel to reconstruct the blood circulation of the two reconstructed fingers. One thumb and two fingers reconstruction: The second toe with the rudder-like dorsal flap was used to reconstruct the thumb. The second and third toe grafts were reconstructed from the opposite side and the ring fingers were taken. The pointed toes are transplanted to the receiving area respectively, and the thumb and fingers are reconstructed in sequence. Reconstruction of the blood circulation by parallel anastomosis. complication 1. Nursing intervention to ensure that the patient is in good coordination with the patient has been in an emergency state, and the postoperative position is forced, which can easily lead to anxiety and sleep disorder. 2, reconstruction refers to the risk of surgery, a failure or complications, patients are often difficult to accept, so nurses should do postoperative health education work. 3, the postoperative ward is absolutely non-smoking, because the smoke contains nicotine, easy to cause vasospasm, prevent active and passive smoking: ensure that the local temperature of the lamp is constant, can not change the lamp distance, and greatly change the position, such as turning over, sitting up, Getting out of bed, etc., will seriously affect the re-creation of the blood circulation, induce vascular crisis, various adverse stimuli and emotional instability, are likely to lead to vascular crisis.

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