先天性并指畸形治疗的回顾性分析  

Retrospective study of treatment in malformation congenital syndactyly

作　　者：吴迪[1] 路来金[1] 宣昭鹏[1] 崔建礼[1] 孙希光[1] 贾晓燕[1] 

机构地区：[1]吉林大学白求恩第一医院手足外科,吉林长春130031

出　　处：《实用手外科杂志》2013年第2期121-123,128,共4页Journal of Practical Hand Surgery

摘　　要：目的探讨先天性并指畸形的治疗体会，规范治疗方法，提高治愈率。方法对我院近两年收治的30例先天性并指畸形患者，采用游离植皮及皮瓣等6种手术方法进行分指。以掌背侧顺行推进皮瓣、掌背侧逆行岛状皮瓣、五角推进皮瓣、局部“V—Y—W”推进皮瓣及菱形皮瓣重建指蹼：以“Z”形和全厚皮片修复指体。结果本组24例总体治疗效果满意，其余6例行二次手术，其中植皮坏死3例，手指瘢痕屈曲挛缩2例，指蹼创面感染、继发瘢痕增生形成不全并指1例。结论并指的手术时机应选择在出生后6个月～2年，并指的手术设计应注重指蹼的重建，重建的方法应首选掌背侧顺行或逆行皮瓣转移术：指体修复应选择全厚皮片，以预防手指的屈曲挛缩。Objective To discuss the treatment experience of congenital symphysodactylia, standardize treatment method, improve the efficiency of treatment. Methods Summarize 30 cases with malformation congenital syndactyly in nearly 2 years in my hospital, used free skin graft and flap to separate the fingers in 6 kinds of surgical methods.By using the dorsal metacarpal anterograde advancing flap,palm dorsal retrograde island flap, the pentagon pushed flap, local V-Y-W promoting skin flap and rhomboid flap for reconstruction the web; with Z shape and skin repair the body finger. Results This group of 24 patients overall treatment effect was satisfactory. There were 6 cases for needing secondary surgery, skin graft necrosis in 3 cases, scar finger flexion contracture in 2 cases, the webbed wound infection, secondary to scar hyperplasia formation in 1 case. Conclusion The operation time of congenital should be chosen after the 6 months to 2 years, the operation should pay attention to the reconstruction of the web-fingered, reconstruction of surgical methods should be preferred palm dorsal anterograde and retrograde flap transfer operation, The repair of fingers should choose the piece, in order to prevent finger flexion contracture.

关 键 词：手 先天性并指畸形 回顾总结性研究 

分 类 号：R726.582[医药卫生—儿科]