先天性并指畸形的分类与治疗  

The classification and treatment of congenital syndactyly

作　　者：于胜吉[1] 王集锷[1] 王志勇[1] 王熙前[1] 陈雨历[2] 

机构地区：[1]山东大学第二医院骨科,250033 [2]山东大学第二医院小儿外科,250033

出　　处：《中华手外科杂志》2002年第1期31-32,共2页Chinese Journal of Hand Surgery

摘　　要：目的　探讨先天性并指畸形的分类与治疗方法。方法　 1988年 1月至 1999年 3月共手术治疗先天性并指畸形 2 4例。结合并连的组织和程度分为 :(1)单纯性完全性并指 4例 ,2指并指一次手术 ,3指并指分二次手术。 (2 )单纯性不完全并指 9例 ,一次手术。 (3 )复杂性完全并指 4例 ,分期手术。(4 )复杂性不完全并指 0例。 (5 )复合性并指 7例 ,单纯行并指分指术。手术主要采用锯齿形切开并指间皮肤 ,皮瓣修复指根部、指蹼 ,皮肤缺损区用全厚皮片植皮的方法。结果　术后随访 6个月～ 10年 ,按Swanson评定方法评价 :优 19例 ,良 4例 ,差 1例。结论　该病根据并连的组织及程度分型后决定治疗方法疗效较好。单纯性完全并指超过Objective To discuss the classification and treatment of congenital syndactyly. Methods From January 1988 to March 1999, 24 cases of congenital syndactyly were treated and classified by fusion tissue combined with the degree of fusion as follows: ①simple complete syndactyly (4 cases). Those involving two fingers could be treated with a single stage operation, while those involving more than three fingers with a two stage operation. ②simple incomplete syndactyly (9 cases), treated with a single stage operation. ③complicated complete syndactyly ( 4 cases), treated with a two stage operation.④complicated incomplete syndactyly(none in our cases).⑤complex syndactyly ( 7 cases), whose treatment only involved the division of fusion fingers. The treatment mainly involved the division of the common skin enveloped by a serrated line, reconstruction of the floor of the web space using flaps, followed by skin grafting to the skin defective area. Results All 24 cases were followed up for 6 months to 10 years and evaluated by Swanson method ,with excellent in 19cases, good in 4 and poor in 1. Conclusions Satisfactory treatment outcome can be obtained in congenital syndactyly when classification by fusion tissue as well as the degree of fusion are considered. Those with complete syndactyly involving more than three fingers should be treated with a two stage operation.

关 键 词：先天性手畸形 并指 显微外科手术 临床分型 

分 类 号：R658.1[医药卫生—外科学]