关键词: 跖趾关节, 掌指关节, 移植, 显微解剖, 修复重建

Abstract:

　　Objective：To provide anatomic basis for reconstructing of metacarpophalangeal joint by total metatarsophalangeal joint and semi-joint transplantation, and summarize the clinical experience of the improved replacement skills．Methods：Anatomic features and blood supply of the second metatarsophalangeal joints were observed and measured in 30 adult cadaveric limbs perfused with red latex. For 14 cases, the second metatarsophalangeal joint transplantation was conducted to reconstruct metacarpophalangeal joint: total metatarsophalangeal joint transplantation in 8 cases, semi-joint transplantation in 6 cases. Early systematic rehabilitation was carried out after the operation. Results: There were rich blood supply and special anatomic features for the second metatarsophalangeal joint. The location of blood vessels and nerve were constant. The follow-up of 5 to 38 months in 12 out of 14 cases showed satisfactory functional recovery was achieved．The movement of second metacarpophalangeal joint was excellent．The result of semi-joint transplantation with joint capsule was the best, total joint transplantation the good. Conclusions：The function of the second metacarpophalangeal joint can be effectively recovered by the improved transfer of the vascularized second metatarsophalangeal joint．The elements for succeed operations including the knowledge of anatomic features of the joints, modified transplantation methods, the repairing of articular branches of nerve, and total reconstruction of joint functions.

Key words: metatarsophalangeal joint, metacarpophalangeal joint, transplantation, microdissection, reconstruction