先天性并指畸形治疗的回顾性分析

目的探讨先天性并指畸形的治疗体会，规范治疗方法，提高治愈率。方法对我院近两年收治的30例先天性并指畸形患者，采用游离植皮及皮瓣等6种手术方法进行分指。以掌背侧顺行推进皮瓣、掌背侧逆行岛状皮瓣、五角推进皮瓣、局部“V—Y—W”推进皮瓣及菱形皮瓣重建指蹼：以“Z”形和全厚皮片修复指体。结果本组24例总体治疗效果满意，其余6例行二次手术，其中植皮坏死3例，手指瘢痕屈曲挛缩2例，指蹼创面感染、继发瘢痕增生形成不全并指1例。结论并指的手术时机应选择在出生后6个月～2年，并指的手术设计应注重指蹼的重建，重建的方法应首选掌背侧顺行或逆行皮瓣转移术：指体修复应选择全厚皮片，以预防手指的屈曲挛缩。

Retrospective study of treatment in malformation congenital syndactyly

Objective To discuss the treatment experience of congenital symphysodactylia, standardize treatment method, improve the efficiency of treatment. Methods Summarize 30 cases with malformation congenital syndactyly in nearly 2 years in my hospital, used free skin graft and flap to separate the fingers in 6 kinds of surgical methods.By using the dorsal metacarpal anterograde advancing flap,palm dorsal retrograde island flap, the pentagon pushed flap, local V-Y-W promoting skin flap and rhomboid flap for reconstruction the web; with Z shape and skin repair the body finger. Results This group of 24 patients overall treatment effect was satisfactory. There were 6 cases for needing secondary surgery, skin graft necrosis in 3 cases, scar finger flexion contracture in 2 cases, the webbed wound infection, secondary to scar hyperplasia formation in 1 case. Conclusion The operation time of congenital should be chosen after the 6 months to 2 years, the operation should pay attention to the reconstruction of the web-fingered, reconstruction of surgical methods should be preferred palm dorsal anterograde and retrograde flap transfer operation, The repair of fingers should choose the piece, in order to prevent finger flexion contracture.