手先天性并指畸形的治疗

目的 介绍手先天性并指畸形的治疗。方法 42例先天性并指畸形患者中，2指并指36例，多指并指6例；软组织并指30例，远节指骨骨性并指12例。均采用并指间背侧矩形皮瓣形成指蹼，指间掌背侧锯齿状皮瓣进行分指。皮瓣移位后指部外露创面用游离植皮覆盖，指端骨外露者用局部皮瓣覆盖。结果 3例的游离植皮部分坏死，创面经换药后愈合；39例的创面均I期愈合。术后1年12例失访，30例的指蹼坡度良好，指尖部软组织饱满，手术指的外展良好。12例术毕因指间关节侧弯，术后用支架纠正畸形，效果满意。结论 并指畸形的治疗关键是指蹼的形成，指间关节侧弯术后使用支架纠正为一良好的方法。

Treatment of hand congenital syndactyly

Objective To introduce the classification and treatment of hand congenital syndactyly.Methods Forty-two cases of congenital syndactyly were involved in the study. Among them, 36 cases had double fingers syndactyly, 6 cases mutiple fingers syndactyly, and 30 cases had syndactyly of soft tissue, 12 cases syndactyly of the distal phalange bone. New web was created using inter-phalangeal dorsal rectangle flap, then the fingers were separated using the serrated flap at the interphalangeal dorsal and volar side. The residual defects along the sides of the seperated finger were covered with full-thickness skin grafts, and exposed bone in fingertip was covered by local flap. Results All cases were primary healing except that partial necrosis of skin graft in 3 cases was healed after dressing change. At postoperative 1 year follow-up, there were 12 cases in loss. Thirty cases had good web space and plump soft tissue fingertip with good finger abduction. Twelve cases were supported with bracing because of lateral deviation at the inter-phalangeal joint and the treatment outcome was satisfying. Conclusion The key treatment of syndactyly is the formation of digital webs. The postoperative bracing therapy is a good procedure if there was inter-phalangeal joint lateral deviation.