摘要
目的探讨应用掌背十字形皮瓣推进重建指蹼治疗小儿先天性并指畸形的临床效果。方法自2020年1月至2021年12月我们共收治中环指并指患儿10例,均采用掌背十字形皮瓣推进重建指蹼,三角形皮瓣缝合修复指侧,皮肤缺损处取腕部全厚皮片植皮覆盖。术后评价采用改良Withey评分标准对指蹼外观进行评价,采用温哥华疤痕量表评估瘢痕增生情况。结果所有病例指蹼、指根部均未植皮,5例中末节指体侧方部分创面通过植皮修复,创面均I期愈合,无感染、皮瓣坏死植皮坏死等早期并发症发生。术后随访时间为5~28个月,平均14.1个月,指蹼深度、宽度、坡度形态与健侧相近,并指术后指蹼未出现蔓延,改良Withey评分平均0.3分,温哥华疤痕量表评分平均1.4分。结论掌背十字形皮瓣推进治疗小儿并指畸形能重建接近正常形态的指蹼及掌指横纹弧度,皮瓣设计简单、理念科学、疗效确切、学习曲线短,适合临床推广。
Objective To investigate the clinical efficacy of reconstruction of finger web space with dorsal metacarpal cross advance flap in children with congenital syndactyly.Methods F rom January 2020 to December 2021,10 children with middle ring finger syndactyly were treated by the reconstruction of finger web space with dorsal metacarpal cross advance flap.The triangular flap was sutured to repair the finger side.The skin defect was covered with full thickness skin graft from the wrist.The improved Withey scoring standard was used to evaluate the appearance of finger web space,and the Vancouver Scar Scale was used to evaluate the cicatricial hyperplasia.Results All the cases had no skin grafts on the web and the root of the finger,and 5 cases had partial wounds on the side of the middle and distal finger body repaired with skin grafts.The wounds achieved primary healing without infection,skin flap necrosis,skin graft necrosis and other early complications.The follow-up time was5 to 28 months with an average of 14.1 months.The depth,width and slope of the finger web space were similar to those of the healthy side,and the finger web did not spread after operation.The average score of the modified Withey score was 0.3,and the average score of the V ancouver Scar Scale was 1.4.Conclusion The cross dorsal metacarpal cross advance flap in the treatment of children's syndactyly can reconstruct the close to normal shape of the web and the curve of palmar and digital creases.The design of the flap is simple,the concept is scientific,the effect is accurate,and the learning curve is short,which is suitable for clinical promotion.
作者
印飞
王军
顾珺
林伟枫
段玉来
Yin Fei;Wang Jun;Gu Jun;Lin Weifeng;Duan Yulai(Department of Pediatric Orthopedics,Wuxi No.9 People's Hospital Affiliated to Suzhou Universily,Wuxi 214000,China;Minhe Hui and Tu Autonomous County People's Hospital,Haidong 810800,China)
出处
《中华手外科杂志》
CSCD
北大核心
2023年第1期8-10,共3页
Chinese Journal of Hand Surgery
基金
海东市科技局东西部协作科研项目(2021-HDKJ-Y12)。
关键词
手畸形
先天性
外科皮瓣
并指
指蹼
Hand deformities,congenital
Surgical flaps
Syndactyly
Web space
