改良指尖舌形皮瓣重建侧甲襞联合矩形皮瓣重建指蹼治疗先天性并指畸形  

Lateral nailfold reconstruction with modified fingertip tongue-shaped flap and finger web reconstruction with rectanguler flap for congenital syndactyly

作　　者：成德亮[1] 张丽君[1] 邱武安[1] 刘国辉[1] 王强[1] 

机构地区：[1]西安交通大学医学院附属红会医院手外中心一病区,710054

出　　处：《临床外科杂志》2016年第8期618-620,共3页Journal of Clinical Surgery

摘　　要：目的探讨应用指尖舌形皮瓣重建侧甲襞联合矩形皮瓣重建指蹼治疗先天性并指畸形的疗效。方法先天性并指畸形患者30例采用指尖舌形皮瓣重建侧甲襞联合矩形形皮瓣重建指蹼,并指之间掌、背侧设计锯齿形切口,切取皮瓣并进行分指矫形术,手指侧方剩余创面行全厚皮片植皮修复。术后预防感染,拆线后指导患者进行功能锻炼。结果 30例患者植皮后有26例完全存活,4例大部分存活,指尖部的舌状瓣及指蹼部位的矩形瓣均存活,手指的功能较术前明显改善,根据Swanson手功能的评定标准。优:25例,良:4例,差:1例。结论应用改良指尖舌形皮瓣重建侧甲襞联合矩形皮瓣重建指蹼治疗先天性并指畸形具有良好的临床效果。Objective To discuss the efficacy of lateral nailfold reconstruction with fingertip tongue-shaped flap and finger web reconstruction with rectanguler flap in syndactyly correction. Methods A total of 30 cases of congenital syndactyly were treated. Zig-zag incisions were made on both the pal- mar and dorsal aspects of the fused fingers to separate the fingers. The lateral nail fold was reconstructed with finger tip tongue-shaped flap. Meanwhile, a rectanguler flap was designed between the dorsal meta- earpophalangel joints to form the finger web. The remainder of the lateral sides of the separated fingers was covered with full-thickness skin graft. Postoperative prophylactic antibiotics were applied. Functional exer- cises were initiated after suture removal. Results Of all cases, 26 cases were completely survived after skin graft,4 cases were most survived. All the fingertip tongue-shaped flap and orthogon flap were sur- vived. After active functional exercise, the function of fingers was obviously improved compared to preoper- ative ones. According to Swanson score, excellent result was obtained in 25 cases, good in 4 cases, and poor in 1 cases. Conclusion The clinical effect of lateral nailfold reconstruction with modified fingertip tongue-shaped flap and finger web reconstruction with rectanguler flap in syndactyly correction is good, and it is a good way in treating congenital syndactyly.

关 键 词：并指畸形 舌形皮瓣 

分 类 号：R726.8[医药卫生—儿科]