小儿并趾分趾后风筝皮瓣推进重建趾蹼的临床研究  

Clinical study on the reconstruction of webbed toes with advanced kite-flap after syndactyl split in children

作　　者：郝立娟[1] 刘迎欣[1] 崔淑媛 法云菲 李济文[1] Hao Lijuan;Liu Yingxin;Cui Shuyuan;Fa Yunfei;Li Jiwen(Department of Hand and Foot Surgery,Yidu Central Hospital of Weifang,Weifang 262500,China;Department of Urology,Yidu Central Hospital of Weifang,Weifang 262500,China)

机构地区：[1]潍坊市益都中心医院手足外科,262500 [2]潍坊市益都中心医院泌尿外科,262500

出　　处：《中华整形外科杂志》2021年第9期993-998,共6页Chinese Journal of Plastic Surgery

摘　　要：目的探讨趾蹼间近端风筝皮瓣修复并趾分趾后趾蹼创面的临床效果。方法采用回顾性病例系列研究分析2010年5月至2019年3月潍坊市益都中心医院采用趾蹼间近端风筝皮瓣修复并趾分趾后趾蹼创面的并趾畸形患儿临床资料。评价皮瓣修复效果满意度(总分5~10分为满意),根据足趾功能及趾蹼坡度、深度评价手术效果。正态分布的计量资料以均数±标准差表示,采用配对样本t检验进行分析。结果共纳入单足两趾并趾畸形患儿10例10足,其中男4例,女6例,年龄6个月~9岁;右侧7例,左侧3例;均为软组织并连,不完全性并趾6足,完全性并趾4足。本组病例皮瓣全部成活,术后随访6~24个月,平均13个月。皮瓣修复效果满意度评分达(8.6±2.7)分,效果均满意。重建后的趾蹼的外观、颜色、弹性、质地与健侧趾蹼近似。末次随访时,分趾后足趾外展度为(43.57±3.82)°,与健侧(44.39±4.25)°比较,差异无统计学意义(P=0.64);趾蹼重建坡度为(42.03±5.49)°,与健侧(43.11±5.83)°比较,差异无统计学意义(P=0.66);重建趾蹼深度为(1.19±0.23)cm,与健侧(1.21±0.27)cm比较,差异无统计学意义(P=0.85)。结论趾蹼间近端风筝皮瓣是修复先天性并趾分趾后趾蹼创面的理想方法之一,但该研究病例数量尚少,随访时间短,患儿后期随生长发育过程的疗效还需进一步了解。Objective To investigate the clinical effect of the proximal interphalangeal kite flap in repairing the wound of the posterior web of the split toe.Methods A retrospective case series study was used to analyze the clinical data of children with syndactyly after toe web wounds were repaired with proximal kite flap between toe webs in the Yidu Central Hospital of Weifang from May 2010 to March 2019.The satisfaction of flap repair effect(the total score is 5-10)and the operation effect according to toe function,toe web slope,and depth were evaluated.The measurement data of normal distribution were expressed in Mean±SD and analyzed by paired sample t-test.Results A total of 10 children with syndactyly were included,including four males and six females,aged from 6 months to 9 years.Seven cases were on the right side,and there were on the left.All were soft tissue connexions,incomplete syndactyly 6 feet,complete syndactyly 4 feet.All flaps survived and were followed up for an average of 13 months(range,6-24 months).The score of satisfaction was 8.6±2.7.The appearance,color,elasticity,and texture of the reconstructed web are similar to those of the uninjured side.At the last follow-up,there was no significant difference between the abduction of the separated toe and that of the healthy side(43.57±3.82)°and(44.39±4.25)°(P=0.64).There was no significant difference between the two groups(P=0.66).The reconstruction depth of the toe web was(1.19±0.23)cm,which was not significantly different from that of the healthy side(1.21±0.27)cm(P=0.85).Conclusions The proximal interphalangeal kite flap is one of the ideal methods to repair the wounds of the posterior web of the congenital syndactyly.However,the number of cases in this study is small,and the follow-up time is short.The curative effect of the children with the growth and development process needs further research.

关 键 词：并指(趾) 修复外科手术 外科皮瓣 风筝皮瓣 趾蹼 儿童 

分 类 号：R726.8[医药卫生—儿科]