一种新的指端移植皮瓣设计方法在Wassel Ⅵ型复拇指畸形治疗中的应用  

Application of a new flap design method of fingertip replantation in the treatment of Wassel type Ⅵ polydactyly

作　　者：陈敏建[1,2] 宋湧 汪怡 陈白烨[1] CHEN Min-jian;SONG Yong;WANG Yi;CHEN Bai-ye(Department of Plastic Surgery,Fujian Maternal and Child Health Hos­pital Affiliated to Fujian Medical University,Fuzhou 350001,China)

机构地区：[1]福建医科大学附属福建省妇幼保健院整形外科,福建福州350001 [2]福建省妇儿重大疾病研究重点实验室,福建福州350001

出　　处：《中国美容整形外科杂志》2021年第11期678-681,共4页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的介绍一种可以应用于WasselⅥ型多指畸形指端移植手术的皮瓣设计方法。方法自2015年1月至2019年10月,福建医科大学附属福建省妇幼保健院整形外科共实施手术3例。术中在桡侧拇指桡侧面设计舌型皮瓣并在尺侧指设计对应的切口,以尺侧指动脉供应指远端指节及近节指骨远端的血运,通过骨断端对合,克氏针固定,并辅以肌腱转移,从而重建新的拇指。术后4~6周拔出克氏针后患儿进行主被动功能锻炼。结果 3例患儿均获12~24个月(平均16.67个月)的随访,取得良好的效果,拇指的稳定性、活动度均接近健侧。患儿父母对术后的功能及外观均表示满意。结论新的设计方法可以为Wassel Ⅵ型多指畸形在指端移植手术提供一种新的思路,但仍需更长时间的随访来验证最后的结果。Objective To introduce a new flap design method which can be applied in the fingertip replantation of Wassel type VI polydactyly. Methods There were 3 operations in the Department of Plastic Surgery of Fujian Maternal and Child Health Hospital from January 2015 to October 2019. The lingual flap was designed on the radial side of thumb and the corresponding incision was designed on the ulnar side of thumb during the operation. The blood supply of distal phalanx and proximal phalanx was provided by ulnar digital artery. The new thumb was reconstructed by combination of the broken ends of bone, fixation of K-wire and tendon transfer. After the K-wire was removed at 4 to 6 weeks after operation, active and passive functional exercises should be carried out. Results All patients were followed up for 12 to 24 months, with an average of 16.67 months. Good efficacy was achieved. The stability and mobility of thumb were close to those of healthy finger. All parents were satisfied with the postoperative function and appearance. Conclusion The new design method can provide a new idea for fingertip replantation of Wassel type Ⅵ polydactyly. Long follow-up is needed to verify the final results.

关 键 词：多指畸形 指端移植 WasselⅥ型 皮瓣设计 

分 类 号：R658.2[医药卫生—外科学]