保留掌背静脉的连续双翼皮瓣在Poland综合征患儿并指手术中的应用  

Single-stage separation of 4-finger with contiguous gull wing flaps and preserving the dorsal metacarpal vein in Poland syndrome

作　　者：沈小芳[1] 印飞[1] 林伟枫 芮永军[1] 田晓菲[2] Shen Xiaofang;Yin Fei;Lin Weifeng;Rui Yongjun;Tian Xiaofei(Department of Pediatric Orthopaedic,Wuxi No.9 People’s Hospital Affiliated to Soochow University,Wuxi 214000,China;Department of Burns and Plastic Surgery,Children’s Hospital,Chongqing Medical University,Chongqing 400014,China)

机构地区：[1]苏州大学附属无锡九院小儿骨科,214000 [2]重庆医科大学附属儿童医院整形外科,400014

出　　处：《中华整形外科杂志》2021年第2期183-186,共4页Chinese Journal of Plastic Surgery

基　　金：江苏省青年医学重点人才培养计划(QNRC2016171)。

摘　　要：目的探讨保留掌背静脉的连续双翼皮瓣一期修复Poland综合征并指畸形的安全性及临床疗效。方法2013年6月至2018年1月,苏州大学附属无锡九院采用保留掌背静脉的连续双翼皮瓣一期修复17例Poland综合征手部短指并指畸形患儿,统计术后皮瓣坏死、指体血管危象发生率,并采用改良Withey并指矫正评分及Swanson手功能评分标准评价手指指蹼外观及功能改善情况,手术前后比较采用配对t检验。结果手术均顺利完成,术后无皮瓣坏死及血管危象发生。随访时间12~41个月,平均23.1个月。重建指蹼深度、宽度、坡度均正常,掌背侧瘢痕较轻。Withey并指矫正评分平均0.17分,Swanson手功能评分术前损失(16.3±1.4)%,术后(3.6±1.3)%,差异具有统计学意义(t=16.469,P<0.01)。结论采用保留掌背静脉的连续双翼皮瓣一期修复Poland综合征并指畸形,手术安全、临床疗效满意。Objective To investigate the safety and clinical effect of single-stage separation of 4-finger with contiguous gull wing flaps and preserving the dorsal metacarpal vein in Poland syndrome.Methods From June 2013 to January 2018,17 children with Poland syndrome were treated by contiguous gull wing flaps.Postoperative follow-up was conducted to observe the incidence of skin flap necrosis and finger vascular crisis.Morphology of the fingers web was evaluated by modified Withey score and Swanson hand function score.Paired t-test was used for intra group comparison.Results The operation was successfully completed and there were no early complications such as vascular crisis and skin necrosis.All patients were followed up for 12-41 months,with an average of 23.1 months.All patients had a reconstruction depth of digital webbed at nearly 1/3 of the proximal phalanx.Both the appearance and function were satisfactory without conspicuous scar.The depth,width and slope of the webbed are normal without conspicuous scar.Withey score was 0-1,with an average score of 0.17.There was significant differences of Swanson hand function score between preoperative(16.3±1.4)%and postoperative(3.6±1.3)%(t=16.469,P<0.01).Conclusions It is safe to treat the syndactyly deformity of Poland syndrome with single-stage separation of 4-finger with contiguous gull wing flaps and preserving the dorsal metacarpal vein.The clinical efficacy is reliable.

关 键 词：并指 外科皮瓣 手畸形 先天性 POLAND综合征 

分 类 号：R726.5[医药卫生—儿科]