改良双翼皮瓣联合足底内侧皮片移植治疗先天性并指畸形  

The investigation of modified double wing flap combined with medial plantar skin graft in the treatment of congenital syndactyly

作　　者：李甲 裴广楠 朱辉 滕道练 李海建 郑大伟 印飞[2] 寿奎水 Li Jia;Pei Guangnan;Zhu Hui;Teng Daolian;Li Haijian;Zheng Dawei;Yin Fei;Shou Kuishui(Department of Pediatric Orthopaedics,Xuzhou Renci Hospital,Xuzhou 221000,China;Department of Pediatric Orthopaedics,Wuxi No.9 People’s Hospital Affiliated to Soochow University,Wuxi 214000,China)

机构地区：[1]徐州仁慈医院小儿骨科,徐州221000 [2]苏州大学附属无锡九院小儿骨科,无锡214000

出　　处：《中华整形外科杂志》2023年第3期273-277,共5页Chinese Journal of Plastic Surgery

摘　　要：目的:探讨应用改良双翼皮瓣联合足底内侧皮片移植治疗先天性并指畸形的临床效果。方法:回顾性分析2019年1月至2022年2月徐州仁慈医院小儿骨科采用改良双翼皮瓣联合足底内侧皮片移植治疗先天性并指畸形患儿的临床资料。术中均存在分离并指后皮肤不足情况,选用足底内侧作为皮片移植供区。术后通过微信及门诊复查随访指蹼形态、手指外形、植皮区及足底内侧供皮区瘢痕挛缩程度,并采用改良Withey并指矫正评分评价手指、指蹼外观,并调查患儿家长满意度。结果:共纳入10例患儿,男5例,女5例,年龄1岁6个月~4岁,平均2岁10个月。术后随访6~18个月,平均11.3个月,所有患儿皮瓣及移植皮片均成活,创面均一期愈合;指蹼深度、宽度、坡度正常,移植皮片与周围皮肤无色差,手指外形美观,植皮区及足底内侧供皮区瘢痕不明显。改良Withey并指矫正评分为0~1分,平均为0.1分。患儿家长对手术效果均满意。结论:足底内侧皮肤与手部皮肤质地接近,改良双翼皮瓣联合足底内侧皮片移植治疗先天性并指后,指蹼形态正常,手部外形美观,瘢痕不明显,且足底内侧供皮区比较隐蔽,不影响行走,术后可获得良好的功能和外形,是治疗皮肤不足的先天性并指畸形的有效方法之一。Objective To explore the clinical effect of the modified double wing flap combined with medial plantar skin graft in the treatment of congenital syndactyly.Methods The data of children with congenital syndactyly treated by modified double wing flap combined with medial plantar skin graft in the Department of Pediatric Orthopaedics of Xuzhou Renci Hospital from January 2019 to February 2022 were retrospectively analyzed.All of them had skin deficiency after separating syndactyly during the operation.The medial plantar was selected as the skin graft donor area.The patients were followed up through WeChat and outpatient review after operations,the contents include the shape of finger web,the shape of finger,the degree of scar contracture in the skin graft area and the medial plantar skin donor area,and the appearance of finger web was evaluated by the modified Withey correction score,and investigate the satisfaction of parents of the children.Results A total of 10 children were included,including 5 males and 5 females,aged 1 year and 6 months to 4 years,with an average age of 2 years and 10 months.There were 8 cases of middle ring finger syndactyly,1 case of ring little finger syndactyly,and 1 case of index middle finger syndactyly.After separating syndactyly,the skin defect area is about 1.0 cm×1.5 cm-1.5 cm×3.0 cm,and a medial plantar full-thickness skin graft with the same area is taken.The postoperative follow-up was 6-18 months,with an average of 11.3 months.All the flaps and grafts survived,and the wounds healed in primary stage.The depth,width and slope of the finger web were normal,there was no color difference between the skin graft and the surrounding skin,and the appearance of the finger was beautiful.The scar in the skin graft area and the medial plantar skin donor area was not obvious.The modified Withey correction score was 0-1,with an average of 0.1.The parents were all satisfied.Conclusion The texture of the medial plantar skin is similar to that of the hand.After the treatment of congenital syndac

关 键 词：并指症 外科皮瓣 儿童 足底内侧 植皮 

分 类 号：R658.2[医药卫生—外科学]