“Z”字成形术与游离植皮术治疗掌腱膜挛缩症的比较  

Comparison of Z-shape plasty with free flap transplantation for treating Dupuytren's contracture

作　　者：薛旦[1] 黄宗坚[1] 

机构地区：[1]浙江大学医学院第二附属医院整形科,浙江杭州310009

出　　处：《中国骨伤》2007年第2期113-114,共2页China Journal of Orthopaedics and Traumatology

摘　　要：目的:讨论掌腱膜挛缩症的病因、发病机制及治疗方法。方法:总结和分析经手术治疗的掌腱膜挛缩症31例(46只手)。行掌腱膜大部切除、手掌及手指挛缩皮肤“Z”字成形术9例(14只手),男8例,女1例;年龄24-78岁,平均(57.2±14.6)岁。行掌腱膜及受累皮肤一并切除加游离植皮术22例(32只手),男20例,女2例;年龄23-64岁,平均(53.7±8.9)岁。结果:随访3个月-14年,平均5年8个月。单纯掌腱膜切除组术后复发率为42.9%(6/14),掌腱膜切除加受累皮肤切除组术后复发率12.5%(4/32),两组术后复发率比较2χ=5.275,P<0.05(P=0.022),差异有显著性统计学意义。结论:彻底切除病变组织,有利于降低手术后的复发率。Objective：To explore pathogenesis and therapeutic methods of Dupuytren＇s contracture. Methods：Thirty-one patients（46 hands） with Dupuytren＇s contracture treated by operation were reviewed. Among 9 patients （14 hands） treated with palmar aponeurosis excision plus and ＂Z＂ shape skin plasty,8 patients were male and 1 patient was female,wtih an average age of （57.2 ± 14. 6） years ranging from 24 to 78 years. Within other 22 patients （32 hands） treated with palmar aponeurosis and skin resection combined with free skin grafting,20 patients were male and 2 patients were female,with an average age of （53.7 ± 8.9 ） years ranging from 23 to 64 years. Results： All the patiemts were followed up averagely for 5 years and 8 months,ranging from 3 months to 14 years. The postoperative recurrence rates were 42. 9% （6/14） and 12. 5% （4/32） in the patients treated with simple palmar aponeurosis excision and those treated with palmar aponeurosis in combination with skin resection respectively. The Chi-square test was used to compare statistically the recurrence rate between the two groups and the result showed the χ^2 was 5.275, P value was less than 0. 05 （ P = 0. 022 ）. Conclusion：Complete resection of affected tissues is effective to decrease postoperative recurrence rate in the treatment of Dupuytren＇s contracture.

关 键 词：手畸形 先天性 皮肤移植 外科手术 

分 类 号：R686.1[医药卫生—骨科学]