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目的:探讨带趾底固有神经和带趾背神经第二趾胫侧皮瓣修复指端缺损的临床疗效。方法:自2015年12月至2017年12月我院收治指端皮肤缺损行第二趾胫侧皮瓣修复的患者40例40指。根据处理方法不同，分为带趾底固有神经组(20例20指)，带趾背神经组(20例20指)。比较两种处理方法远期患者手功能满意度、皮瓣瘢痕外形、指活动度、受区皮瓣感觉(痛觉、温度觉、两点分辨觉)、供区趾腹感觉(痛觉、温度觉、两点分辨觉)，分析疗效。结果:带趾底固有神经组术后皮瓣及植皮全部存活。随访19～22个月，平均21个月，手功能满意度评分为(7.15±1.18)分；瘢痕定量评分为(3.85±1.09)分；指关节活动度为(245.50±18.35)°；皮瓣两点分辨觉为7～13 mm，平均9.35 mm，供区趾腹两点分辨觉为9～15 mm，平均11.55 mm。带趾背神经组术后皮瓣及植皮全部存活。随访18～23个月，平均20个月，手功能满意度评分为(7.05±1.15)分；瘢痕定量评分为(3.90±1.02)分；指关节活动度为(251.20±14.65)°；皮瓣两点分辨觉为5～9 mm，平均7.10 mm，供区趾腹两点分辨觉为6～10 mm，平均为7.95 mm。带趾背神经组术后皮瓣两点分辨觉、供区趾腹的两点分辨觉优于带趾底固有神经组(n P0.05)。n 结论:应用保留趾底固有神经，缝合趾背神经的第二趾胫侧皮瓣修复手指指端软组织缺损，在改善指腹感觉的同时减少了对供区的损伤，是一种修复指端皮肤软组织缺损的较好术式。“,”Objective:To explore the clinical efficacy of the second toe tibial flap with proper plantar digital nerve and dorsal digital nerve for repair of the fingertip defects.Methods:From December 2015 to December 2017, 40 cases (40 fingers) of the fingertip defects were treated in our hospital. According to the different treatment methods, the patients were divided into two groups: the group with proper plantar digital nerve (20 fingers in 20 cases) and the group with dorsal digital nerve (20 fingers in 20 cases). The long-term satisfaction of hand function, scar shape of skin flap, finger activity, sensation of skin flap in recipient site (pain, temperature, two-point discrimination), sensation of the donor area of the toe pulp (pain, temperature, two-point discrimination) were compared and the clinical efficacy was analyzed.Results:All the flaps and grafts survived in the group with proper plantar digital nerve. The follow-up period ranged from 19 to 22 months with an average of 21 months. The satisfaction score of hand function was 7.15±1.18, the quantitative score of scar was 3.85±1.09, the degree of finger joint activity was (245.50±18.35)° and the two-point discrimination of the flap was 7 to 13 mm, with an average of 9.35 mm. The two-point discrimination of donor area was 9 to 15 mm, with an average of 11.55 mm. All the flaps and grafts survived in the group with dorsal digital nerve. The follow-up period ranged from 18 to 23 months with an average of 20 months. The satisfaction score of hand function was 7.05±1.15, the quantitative score of scar was 3.90±1.02, the degree of finger joint activity was (251.20±14.65)° and the two-point discrimination of flap was 5 to 9 mm, with an average of 7.10 mm. The two-point discrimination of donor area was 6 to 10 mm, with an average of 7.95 mm. The two-point discrimination of the flap and the donor area of dorsal digital nerve group was better than that of proper plantar digital nerve group (n P0.05).n Conclusion:The second tibial flap with proper plantar digital nerve and suturing dorsal digital nerve was used to repair the soft tissue defects of the fingertip, which could not only improve the sensation of the finger pulp, but also reduce the damage to the donor area. It is a better method to repair the skin and soft tissue defects of the fingertip.