指动脉轴型皮瓣扩容矫形治疗Wassel Ⅲ～Ⅴ型复拇指畸形的临床疗效(附14例报告)  

Clinical efficacy of digital arteria axial flap augment volume in treatment of Wassel type Ⅲ-Ⅴcongenital thumb duplication:A report of 14 cases

作　　者：窦邦现[1] 李红卫[1] 程富礼[2] 白晨平[1] DOU Bangxian;LI Hongwei;CHENG Fuli;BAI Chenping(First Department of Hand Surgery,Orthopedics Hospital,Zhengzhou City,Henan Province,Zhengzhou450003,China;First Department of Pediatric Orthopaedics,Orthopedics Hospital,ZhengzhouCity,Henan Province,Zhengzhou 450003,China)

机构地区：[1]河南省郑州市骨科医院手外一科,河南郑州450003 [2]河南省郑州市骨科医院小儿骨科一科,河南郑州450003

出　　处：《吉林大学学报（医学版）》2018年第3期620-623,共4页Journal of Jilin University：Medicine Edition

基　　金：河南省科技厅重大科技专项基金资助课题(182102310416)

摘　　要：目的:探讨指动脉轴型皮瓣扩容矫形治疗WasselⅢ~Ⅴ型复拇指畸形的临床疗效,为该病的临床治疗提供依据。方法:对14例患有WasselⅢ~Ⅴ型复拇指畸形儿童进行拇指扩容矫形手术,采用显微外科技术,设计1个窄而长并携带动脉血运的皮肤及软组织皮瓣,扩容患指软组织,重建患指周径和外观。手术前后测量健指与患侧指周径和外观。结果:术后所有皮瓣完全成活,甲粗隆处、远指间关节处、近节指骨中段处、掌指关节和掌骨中段处测量所得数据表明重建扩容患指平均周径为健指的89%~104%,患指外观接近健指。结论:使用带指动脉的轴型皮瓣扩容矫形治疗WasselⅢ~Ⅴ型复拇指畸形不仅易于切取且外观良好,是一种有效改善患指细而小的手术方式。Objective：To explore the clinical efficacy of digital arteria axial flap augment volume in the treatment of Wassel type Ⅲ-Ⅴ congentital thumb duplication,and to provide the basis for its clinical treatment.Methods：The thumb augment volume surgery was performed in 14 children with Wassel type Ⅲ-Ⅴ congenital thumb dupliation.A narrow and long flap with vascular vessel and soft tissue was designed with microsurgical technique to augment the soft tissue of the reconstructed thumb and reconstruct the perimeter and appearances of the reconstructed thumb.The perimeters and appearences of the reconstructed thumb and healthy thumb were detected before and after surgery.Results：All the flaps were survived after the surgery.The average perimeter of the reconstructed thumb was 89%-104% relative to the healthy contralateral thumb based on the data detected from the tuberositas unguicularis,proximal interphalangeal joint,proximal phalanx midshaft,metacarpophalangeal joint and metacarpal midshaft.The appearance of reconstructed thumb was more similar to that of healthy thumb.Conclusion：The digital arteria axial vascular flaps which are used to augment the volume of reconstructed thumb of Wassel typeⅢ-Ⅴ congenital thumb duplication can be easily obtained and the reconstructed thumbs have better appearences.The surgery is an effective way to improve the thin and small appearences of reconstructed thumbs.

关 键 词：复拇指畸形 轴型动脉皮瓣 扩容 儿童 

分 类 号：R682[医药卫生—骨科学]