Preliminary applications of the 3D-CTA assisted digital designing of the second toe transfers for the reconstruction of finger / 中华显微外科杂志

ABSTRACT

Objective To investigate the clinical significance of the 3D-CTA (three-dimensional computed tomography angiography)assisted design of finger reconstruction the second toe.Methods Between June 2010 and January 2013,five patients with finger defect received 3D-CTA assisted finger reconstruction surgeries using the second toe.Preoperative ipsilateral foot and hand 3D-CTAs were conducted and the 3D digital models were analyzed.The accurate positions and adjacent relations of vessels in both donor and recipient site were precisely marked and then the calibers of the vessels were measured.Four cases received thumb reconstructions and 1 case received little finger reconstruction.All of these surgeries were second-stage.According to Gu Yudong's classification of finger defectsecond degree 2 cases,third degree 2 cases,five degree 1 case(little finger).Results With the help of 3D-CTA,five patients in this group had no vascular crisis,and all fingers survived successfully.With 4-12 months' follow-up,the algesthesia and thalposis of the reconstructed fingers gained good recoveries.The two-point discrimination was 5-10 mm.Tthe range of flexion of interphalangeal joint was 10 °-30 °.The range of flexion of the metacarpophalangeal joints was 35 °-80 °.And all patients restored walking and bearing functions with 3 months after surgeries.Conclusion The 3D-CTA reconstruction based digital model of ipsilateral foot and hand can objectively reflect the real situation of the vessels in both donor sites and recipient sites (exist of variations,routes and the calibers of the vessels),thus improve the success rate of surgery.