不同术式治疗小儿并指畸形临床研究

目的探讨不同术式及手术时间治疗小儿先天性并指的临床疗效。方法选取2010年1月至2016年12月沈阳医学院附属中心医院收治的50例先天性并指患儿,根据指蹼成形术的不同分为A组(n=27)和B组(n=23)。A组采取掌背侧逆行岛状皮瓣重建指蹼,B组采取掌背侧三角形皮瓣形成指蹼,比较不同术式对手部外观及功能恢复的影响。结果两组患儿间瘢痕挛缩、皮肤色泽、指蹼爬升、指蹼宽度和深度间差异比较,差异无统计学意义(P>0.05)。不同年龄段,挛缩的发生概率比较,差异有统计学意义(P<0.05)。在年龄≤1.5岁的患儿中,A组和B组患儿挛缩的发生概率分别为42.9%(3/7)和33.3%(2/6),两组间比较,差异无统计学意义(P>0.05)。结论两种术式治疗先天性并指畸形均能获得良好的临床疗效,但需要掌握手术时机,才能达到最佳的临床效果。

Clinical effects of different methods and operation time for children with congenital syndactylia

Objective To investigate the clinical effects of different methods and operation time for children with congenital syndac-tylia. Methods A retrospective study was performed on 50 cases of children with congenital syndactylia who were admitted from Janu-ary 2010 to December 2016. According to different fingerweb arthroplasty methods,children were divided into Group A(n = 27)and Group B(n = 23). Children in Group A were performed fingerweb arthroplasty using reversed island flap on the dorsal side of the palm,the others in Group B were used triangle flap of the dorsal side of the palm;the appearance and function recovery of different op-erations were compared. Results There were no statistically significant differences in scar contracture,skin color,fingerweb mobility, fingerweb width and depth between the two groups(P > 0. 05). In different age groups,the occurrence rate of scar contracture had sta-tistically significant difference(P < 0. 05). For the children younger than one year and a half,the occurrence rate of scar contracture in Group A and Group B was 42. 9％ and 33. 3％,respectively,there was no statistical significant difference between the two groups(P <0. 05). Conclusion Both of these two methods may get satisfied clinical effect,the proper operation time should be grasped to achieve the best clinical effect.