摘要
目的 探讨不伴植皮术的指根背侧圣诞树形推进瓣在矫正先天性单纯型完全或不完全性并指畸形中的应用疗效。方法 回顾2018年1月至2021年3月,在我科完成的23例使用圣诞树形背侧推进瓣重建指蹼、且不伴植皮术的并指分离术病例,术后随访6~43个月,平均18.2个月。最终随访时间以患者健侧手为对照,使用视觉模拟量表来评估患手及指蹼的外形美观程度,使用温哥华瘢痕量表来判断术区的瘢痕增生情况,并分别测量患指PIP关节和DIP关节的主动关节活动度来评估患指活动功能。结果 本组23例重建指蹼均显示良好的宽度和合理倾斜度(约45°),患儿家长对患手外形美观度满意,术区无明显增生性瘢痕遗留。患指关节的主动活动度约为155°,与健侧相比差异无统计学意义,表明患手无明显活动功能障碍。结论 不伴植皮术的指根背侧圣诞树形推进瓣设计合理,手术操作简便,在矫正先天性单纯型并指畸形中方法有效可靠。
Objective To investigate the effect of dorsal Christmas tree-shaped advancement flap without skin graft in the correction of congenital simple complete or simple incomplete syndactyly. Methods Twenty-three cases of web space reconstruction without skin grafting were retrospectively investigated. The mean follow-up was 18.2months( range: 6-43 months). Using the healthy hands as the control group, we evaluated the aesthetic appearance of the operated hand with the Visual Analog Scale. The Vancouver Scar Scale was used to assess the hypertrophic scar. The active range of motion of PIP and DIP joints of the affected digits were measured to evaluate the hand function. Results The reconstructed web space appeared satisfactory width and a physiological slope of 45°. Patient parents were mostly satisfied with the appearance of the affected hand. No obvious hypertrophic scar was noted. The active range of motion of the affected digit was about 155°, indicating no severe hand dysfunction. Conclusions The dorsal Christmas tree-shaped advancement flap without skin graft is well-designed and easily conducted. It can achieve good aesthetic and functional outcomes in the correction of congenital syndactyly.
作者
曹怡
姜浩
杜子婧
韩冬
CAO Yi;JIANG Hao;DU Zi-jing;HAN Dong(Department of Plastic and Reconstruction Surgery,Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai,200041,China)
出处
《中国骨与关节杂志》
CAS
2022年第12期898-902,共5页
Chinese Journal of Bone and Joint
基金
上海市科委项目-上海市整形与修复重建临床医学研究中心(22MC1940300)。
关键词
并指
手畸形
先天性
外科皮瓣
Syndactyly
Hand deformities
Congenital
Surgical flaps
