烧伤后末节指腹与手掌瘢痕粘连畸形的整复

目的探究烧伤后末节指腹与手掌瘢痕粘连畸形的整复处理要点。方法对37例52指烧伤后末节指腹与手掌瘢痕粘连形成的严重畸形采取切疤、松解挛缩、植全厚皮手术,并在术后变相应用软组织扩张技术的原理,在弹性加压包扎的基础上采用渐进式撑顶方法以延长短缩的肌腱、神经、血管等软组织,逐渐使极度屈曲的患指伸直。结果随访半年～3年,34例47指外形和功能基本恢复正常;合并侧偏屈畸形3例5指,虽然腹屈畸形被矫正,但侧偏屈畸形改善不明显。结论采取切疤、松解挛缩、植全厚皮手术,并在术后变相应用软组织扩张技术的原理,在弹性加压包扎的基础上采用渐进式撑顶方法能较好地矫正烧伤后末节指腹与手掌瘢痕粘连形成的严重腹屈畸形,但对侧偏屈畸形效果不佳。

Repairing the deformity of the last finger section abdomen adhering palm of hand by cicatrical contracture after being burned

Objective To explore the gist of repairing deformity of the last finger section abdomen adhering palm of hand by cicatrical contracture after being burned.Methods A retrospective study was made on 52 fingers of 37 cases with deformity of the last finger section abdomen adhering palm of hand by cicatrical contracture after being burned.The deformities were repaired by excluding scar,loosening the contracture,and covering the secondary skin defects with full thickness skin grafting.After operation,the tenet of skin and soft-tissue expansion was quoted to invent the method of gradual supporting and withstanding finger under reliable pressure binding up with springy bandage,which can gradually straighten the extreme zigzag finger by extending the shorten tendon,nerve,blood vessel,and other soft tissue.Results After a follow-up of 6 to 36 months,the appearance and function of 47 fingers of 34 cases was recovered to fundamental normality after treatment.The abdominal winding deformity of other 5 fingers of 3 cases combining side winding was corrected,but the side winding deformity was not rectified.Conclusion The extreme abdominal winding deformity of the last finger section abdomen adhering palm of hand by cicatrical contracture after being burned can be corrected by excluding scar,loosening the contracture,covering the secondary skin defects with full thickness skin grafting,and after operation making using of the method of gradual supporting and withstanding finger under reliable pressure binding up with springy bandage.But the side winding deformity could not be rectified with this method.