Reconstruction of thumb V degree and VI degree defect

Suitable for thumb V degree, VI degree defect. Treatment of diseases: hand trauma, open hand injury Indication Suitable for thumb V degree, VI degree defect. 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 A second toe (with a metatarsophalangeal joint) with a diamond-shaped dorsal flap was used to reconstruct the thumb. The dorsal incision is designed as a rhomboid flap with the second toe as the axis, (3 ~ 4) cm * 3 ~ 4) cm. The flap is first lifted from the temporal side, so that the flap has a dorsal vein and a dorsal arch. In the foot of the foot, the saphenous back and the great saphenous vein of the foot are exposed, and the proximal end is separated retrogradely, and the branch is cut and ligated, and is released to the ankle joint. The flap was lifted from the temporal side with a dorsal vein and a dorsal arch. Pick up the entire diamond flap. The second toe procedure was performed as described above, and the dorsal artery of the foot and the dorsal artery of the first dorsal and bilateral toe nerves were separated. Cut the toe length, short extensor tendon and long flexor tendon. The second metatarsal bone was cut in the middle of the humerus. A tongue-shaped incision is made at the stump of the thumb, and the flap is lifted. Separation of the long, short extensor tendon and flexor tendon. Incision at the lateral line of the palm of the ring, the finger flexor tendon is cut off and extracted from the wrist incision, and the tendon is pulled out of the thumb wound through the subcutaneous tunnel of the fish to prepare for the function of the thumb to palm. The radial artery and cephalic vein were separated in the wrist incision. The vascular pedicle of the second toe with the dorsal flap of the foot is severed and moved to the recipient area. The metacarpal metatarsal bone was fixed with a cross, the periosteum was sutured, and the tension was adjusted. The thumb length, short extensor tendon and flexor hallucis longus were sutured. The ring finger flexor tendon is sutured with the tendon of the second toe sacral muscle and the interosseous muscle to reconstruct the palm function of the reconstructed thumb. Stitch the two sides of the toe, finger nerves. Stabilize the veins and veins and reconstruct the blood circulation of the reconstructed thumb. Trim and adjust the flap so that the diamond flap wraps around the wound and forms a thumb. The medium-thickness skin graft was transplanted on the back of the foot, and the suture type compression suture was used to survive. The temporal wound can be sutured directly. The appearance and abduction function of the thumb were reconstructed half a year after surgery.

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