飞机形皮瓣成形趾蹼修复第4、5趾多并趾畸形  

Plane-shaped flap for reconstruction of the web space in polysyndactyly of the fifth toe fused with the fourth toe

作　　者：王有晶 沈卫民[1] 崔杰[1] 陈建兵[1] 季易[1] 陈海妮[1] 严俊[1] 高庆文[1] 韩涛[1] 邹继军[1] Wang Youjing;Shen Weimin;Cui Jie;ji Yi;Chen Haini;Yan Jun;Gao Qingwen;Han Tao;Zou Jijun(Department of Burn and Plastic Surgery,Children's Hospital Affiliated to Nanjing Medical University,Nanjing 210008,China)

机构地区：[1]南京医科大学附属儿童医院烧伤整形科,210008

出　　处：《中华医学美学美容杂志》2019年第6期500-503,共4页Chinese Journal of Medical Aesthetics and Cosmetology

摘　　要：目的探讨飞机形(Plane)皮瓣治疗第4、5趾多并趾畸形的效果。方法2015年1月至2016年12月,南京医科大学附属儿童医院烧伤整形科收治小趾多趾伴第4、5趾并趾畸形62例(男32例,女30例;年龄6个月至5岁,平均2.1岁)81侧足,其中完全性多并趾53例,不全性多并趾9例。53例有小趾主干不同程度的腓偏畸形及短趾畸形。术中切除多趾,用关节面成型及关节囊修补矫正小趾腓偏畸形,用Plane皮瓣重建趾蹼,趾侧创面用多趾残余皮肤做成皮瓣包裹关闭,同时延长小趾远端软组织长度,形成与正常小趾类似外观。结果81侧足均未植皮,创面均一期愈合,无感染和皮肤坏死。术后平均随访12个月,重建趾蹼宽度、深度及坡度正常,小趾腓偏得以完全矫正,短趾畸形得到不同程度改善,无趾侧瘢痕挛缩,甲襞外观与正常小趾基本一致。结论Plane皮瓣治疗4、5趾多并趾畸形,能够重建形态良好的趾蹼,避免了植皮,改善小趾的畸形,是一种矫正4、5趾多并趾畸形的好方法。Objective To discuss the application of plane-shaped flaps for reconstruction of the web space in polysyndactyly of the fifth toe fused with the fourth toe.Methods A total of 62 cases(81 feet)with polysyndactyly of the fifth toe fused with the fourth toe were involved in the study,53 of which were incomplete and 9 were complete fusion of the fourth and fifth toe.The fifth toe showed various degrees of fibular clinodactyly and minor deformities.Excision of polydactyly and then using arthroplasty or osteotomy correction deviation was for fibular clinodactyly.All plane-shaped flaps were used for reconstruction of the web space deeply,and the lateral sides of toes were closed with flaps and the distal soft tissues of polydactyly were used lengthening the reconstructed fifth toe.Brachydactylias were improved,and nail folds were reconstructed.Thus,the appearances reached the normal level.Results All the webs were reconstructed primarily without skingraft.After 12 months of follow-up,these reconstructed web space were satisfied with good appearances of width,depth and gradient.The fibular clinodactyly was completely corrected,and brachydactylias were corrected in various degrees.Nail folds reached the normal ones.Conclusions Plane-shaped flap in polysyndactyly of the fifth toe fused with the fourth toe for reconstruction of the web space is satisfactory.The reconstructed webs not only achieves good appearance,but also avoids skin grafts.It is one of the best choices of the polysyndactyly treatment.

关 键 词：修复外科手术 儿童 并趾 多趾 趾蹼重建 飞机形皮瓣 

分 类 号：R68[医药卫生—骨科学]