烧伤后手指严重屈曲挛缩和指蹼粘连的Ⅰ期修复

目的：探索应用一种新的手术方式一次性修复烧伤后手指屈曲畸形和指蹼粘连。方法：在指蹼间作平行纵切口，近端向手背侧延伸，远端向掌指横纹处延伸，指蹼间形成矩形掌背双蒂皮瓣，腹部取全厚皮片移植于双蒂皮瓣两侧和手指创面，后期加强功能锻炼。结果：自1999年12月至2002年5月，共完成24例37只烧伤后患手，术后均一次性矫治了手部指蹼粘连和手指屈曲畸形，经6个月以上临床随访，患手功能及外形均可。结论：本手术方法在指蹼间保留皮瓣，两侧植皮，切口延伸同时解决手指屈曲畸形，方法简便，创伤小，减少了住院次数并降低了住院费用，术后功能外观均好，值得推广。

Repair flexure malformation of finger and digitalweb-space adhesion at one stage

Objective To investigate a new surgical method which is used to repair digitalweb-space adhesion and flexure malformation of finger at one surgery. Methods A parallel and lengthwise incision was made between digitalweb-space,the proximal end of incision extended to the back of hand,while the distant end extended to metacarpophalangeal striate,and then,a rectangular double-pedicel flap was created between digitalweb-space.The full-thickness skin was grafted from abdomen to wound of both sides of flap and metacarpophalangeal joint or fingers.Function exercise was strengthened after operation. Results Twenty-four patients admitted in our unit with 37 injury hands resulting from burn or scald were treated from Dec 1999 to May 2002.The digitalweb-space adhesion and flexure malformation of finger were remedied at one session.The hands worked well and the appearance was more natural,all of the patients were satisfied with the result for over six months follow up. Conclusion It is simple,safe and effective that the operation which keep flap between digitalweb-space and skin-grafted at both sides of flap repaired digitalweb-space adhesion,and solved flexure mallformation of fingers by incision extension.This operation can decrease in expenditure and the length of hospital stay.