[Clinical evaluation of frozen-phalanx-joint-tendon-sheath composite tissue allograft].
OBJECTIVE
To evaluate clinical result of reconstructed thumb and finger with a free hallux nail flap(HNF) and frozen-phalanx-joint-tendon-sheath composite tissue allograft in 270 cases.


METHODS
The patients were followed up with reexamination in the ambulant clinic, communication, X-ray photography, lab-examination, isotope 99mTc MDP and reoperation. The data were analyzed by statistics or proved by clinical observation, which were followed up for five years in average (ranging from five months to sixteen years).


RESULTS
Enveloping the allogeneic finger composite tissue with self-HNF and pieces of phalanx of great toe, it could reconstruct a thumb or finger with good contour and nutrition. The excellent rate of opposition function of the reconstructed thumbs was 71.91%. The sense of the fingers recovered after 3 months to 8 months of operation. Two-point discrimination was 3 mm to 15 mm. The junction between implanted allo-phalanges and auto-phalanges could be hastened by implanted with vascularized autogenous phalanx pieces in the HNF. The isotope 99mTc MDP was used to take X-ray photography in 24 cases for four months to 9 years and seven months, which showed that the blood vessels grew into the allo-phalanges. However, the Charcot's arthropathy of allogeneic joints and bony absorption still could be seen in some cases. That might be concerned with chronic abrasion of joint or chronic rejection of host to graft.


CONCLUSIONS
The operation is fit for repairing the defect of thumb or finger in any degree. The implanted vascularized self-phalanx pieces can promote bone union, but it can not prevent the allogeneic joints from arthropathy or bone absorption.
Hou
M Z
MZ
Department of Plastic Surgery, First People's Hospital, Shanghai, P. R. China 200080.
Huang
X G
XG
Jia
W X
WX
D000293:Adolescent; D000328:Adult; D015925:Cryopreservation; D005260:Female; D005383:Finger Injuries / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures; D013524:Surgical Flaps; D013933:Thumb / Q000293:injuries*; D014034:Toes / Q000637:transplantation*; D016042:Transplantation, Heterotopic; D014184:Transplantation, Homologous