手术切除加连续“Z”字改型皮瓣治疗掌腱膜挛缩症的疗效观察  

Treatment of Palmar Aponeurosis Contracture by Surgical Excision Plus Continuous “Z” Modified Skin Flap

作　　者：李强[1] 刘新权[1] 冷元曦[1] 周雄[1] 支乐[1] LI Qiang;LIU Xing-quan;LENG Yuan-xi;ZHOU Xiong;LE Zhi(Department of Six Orthopaedics of Nanchang Hongdu Hospital of Traditional Chinese Medicine of jiangxi Province,Nanchang 330006 China)

机构地区：[1]南昌市洪都中医院,江西南昌330000

出　　处：《现代诊断与治疗》2018年第19期3025-3027,共3页Modern Diagnosis and Treatment

摘　　要：目的观察手术切除掌腱膜加连续"Z"字改型皮瓣治疗掌腱膜挛缩症的临床疗效。方法对2013年3月～2017年3月我科收治的11例掌腱膜挛缩症患者,采用手部挛缩带为中轴线设计锯齿状连续"Z"型切口,形成连续"Z"字形皮瓣,彻底切除病变掌腱膜后通过连续"Z"型皮瓣改型修复创面,不需植皮或转移皮瓣修复就能闭合创口。结果术后切口均I期愈合,术后随访时间3～36(平均13)个月,手指功能明显改善,屈伸活动基本正常,皮肤无明显挛缩及瘢痕增生,感觉无异常。结论手术切除病变掌腱膜加连续"Z"字改型皮瓣治疗Ⅲ期和Ⅳ期掌腱膜挛缩,能完全彻底切除掌腱膜的同时不需植皮或转移皮瓣修复就能闭合创口,大大减少了手术时间及手术创伤,避免了植皮和(或)转移皮瓣带来的相关并发症,具有手术时间短、创伤小、恢复快、愈合良好等优点,值得临床推广应用。Objective To observe the clinical effect of surgical removal of palmar fasciae and continuous"Z"modified flap in the treatment of palmar fascia contracture.Methods From March2013to March2017,11cases of palmar fascia contracture were treated by using the hand contracture strip as the central axis to design the serrated continuous“Z”incision.A continuous“Z”shaped skin flap was formed to completely remove the palmar aponeurosis and reconstruct the wound through continuous“Z”skin flap.Wound closure can be achieved without skin grafting or transfer of skin flap.Results All the incisions healed by I and the follow-up time was3~36months,with an average of13months.Finger function improved significantly,flexion and extension activities were basically normal,no obvious contracture and scar hyperplasia,no abnormal feeling.Conclusion Surgical resection of the palmar aponeurosis and continuous"Z"flaps for the treatment of the contracture of the palmar aponeurosis in stage III and IV can completely remove the palmar aponeurosis completely without skin grafting or the transfer of the flap to repair the wound.The operation time and surgical trauma were greatly reduced,and the complications associated with skin grafting and(or)transfer flap were avoided.It has the advantages of short operation time,small trauma,quick recovery and good healing.It is worthy of clinical application.

关 键 词：手术切除 掌腱膜挛缩症 皮瓣 

分 类 号：R628[医药卫生—整形外科]