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目的:探讨应用游离的第2足趾近侧趾骨间关节复合组织移植再造手指指骨间关节缺损，同期采用 趾近节腓侧带蒂骨皮瓣转移修复第2趾趾骨间关节供区缺损的临床疗效。 方法:从2020年12月至2023年4月，顺德和平外科manbet官网登录 手显微外科收治手指指骨间关节缺损患者共9例9指，男7例，女2例，年龄18～55岁，平均31岁，采用游离的第2足趾近侧趾骨间关节复合组织移植再造手指指骨间关节缺损，同期采用 趾近节腓侧带蒂骨皮瓣转移修复第2趾趾骨间关节供区缺损，指导适当的功能锻炼，术后8～12周拔除克氏针。通过门诊复查、电话及微信等对患者进行随访，对再造指骨间关节及供区足部的外观及功能恢复情况进行复查，用中华医学会手外科学会关于拇和手指再造功能评定试用标准、温哥华瘢痕量表评分(VSS）、美国足踝关节协会(AOFAS)足功能评分标准进行评估。 结果:随访6～30个月，9例患者术后再造指骨间关节均成活，外形完整、美观；再造的指骨间关节功能恢复良好，根据中华医学会手外科学会关于拇、手指再造功能评定试用标准，平均分12分，其中6例为优，2例为良，1例为可。术后足部供区 趾及第2足趾外观及功能均恢复良好，用VSS评价供区第2足趾瘢痕平均为4分；供区的足部保留5个趾体，外形饱满、完整美观，根据AOFAS足功能评分标准，平均评分达到95分，均为优。 结论:应用游离第2足趾近侧趾骨间关节移植再造手指指骨间关节同期采用 趾近节腓侧带蒂骨皮瓣转位修复供区，在修复指骨间关节缺损、恢复手指指骨间关节功能的同时修复足部供区的外观及功能，可获得良好的临床疗效。

Objective:To investigate the clinical efficacy of transfer of a free segment of the proximal second toe interphalangeal joint composite tissue flap in reconstruction of defects of interphalangeal joint of fingers, and simultaneously reconstruct the donor site defect left with the second toe by a transfer of a pedicled bone flap of the fibular proximal great toe.Methods:From December 2020 to April 2023, a total of 9 patients with interphalangeal joint defects of fingers were treated in the Department of Hand Microsurgery of Shunde Heping Surgery Hospital. The patients were 7 males and 2 females, aged 18-55 years old, with an average age of 31 years old. Firstly, transfers of a free segment of the proximal second toe interphalangeal joint composite tissue flap were performed to reconstruct the defects of finger joints. Simultaneously in the surgery, transfers of the fibular pedicled bone flap of the proximal great toe were conducted to reconstruct the donor site defects left in the second toe. Patients were instructed with appropriate postoperative functional exercises. K-wires were removed at 8-12 weeks after surgery. Outpatient visits, telephone and WeChat follow-ups were conducted to evaluate the appearance and functional recovery of the reconstructed interphalangeal joints and donor feet. Evaluation Trial Standards of Upper Limb Partial Functional of Hand Surgery of Chinese Medical Association, Vancouver Scar Scale (VSS) and American Orthopedic Foot and Ankle Society (AOFAS) foot function scoring standards were employed in the evaluation.Results:Postoperative follow-up lasted for 6 to 30 months. All of the 9 interphalangeal joint composite tissue flaps in the fingers survived with complete and good appearance. Function of the reconstructed interphalangeal joints of the fingers recovered well. According to the Evaluation Trial Standards of Upper Limb Partial Functional of Hand Surgery of Chinese Medical Association, the average score achieved 12 points, with 6 patients of excellent, 2 of good and 1 of fair. After surgery, the appearance and function of the donor great toes and second toes all recovered well. The average score of the scars in donor second toe evaluated by VSS was 4 points. All the donor feet were kept with 5 toes, with full, intact and good in appearance. According to the AOFAS foot function scoring standard, the average score achieved 95 points, and were excellent.Conclusion:Application of transfer of free proximal segment of interphalangeal joint composite tissue flap of the second toe in reconstruction of the interphalangeal joint defect of a finger, and simultaneously reconstruct the defect left with the donor second toe with a fibular proximal great toe flap pedicled with bone tissue can achieve good clinical efficacy in reconstruction of the defects of interphalangeal joint of fingers, restore the function of the interphalangeal joint of fingers and the appearance and function of the donor foot.