两种指蹼成形术治疗小儿并指畸形的疗效对比

Comparison of Two Kinds of Finger Web Plasty in the Treatment of Syndactyly in Children

目的:探讨小儿并指畸形不同指蹼成形术治疗的疗效.方法:回顾性分析本院2015 年9 月至2019 年2 月收治的 19 例掌背穿支皮瓣滑移术治疗患儿(A组)和 18 例掌背岛状皮瓣术治疗患儿(B组).术后经 1 年随访,对比两组指蹼皮瓣成活情况、手功能恢复情况、疼痛程度及家属美观满意度.结果:术后 1 年随访,两组患者的指蹼皮瓣全部成活(P>0.05);两组 Fugl Meyer运动功能评分(FMA)评分高于术前,两组比较,差异无统计学意义(P>0.05);B组术后 7d、1 个月视觉模拟评分(VAS)较A组低(P<0.05);B组术后 1 年美观满意度高于A组(P<0.05).结论:掌背穿支皮瓣滑移术、掌背岛状皮瓣术治疗小儿并指畸形均能获得理想的指蹼皮瓣成活率及手功能改善,但掌背岛状皮瓣术的实施带来的疼痛程度轻微,且家属对美观度的满意度高,更具优势.

Objective:To explore the efficacy of different finger web plasty for syndactyly in children.Methods:A retrospective analysis was made of 19 children treated with dorsal metacarpal perforator sliding flap in our hospital from September 2015 to February 2019,which were set as group A,and 18 children treated with dorsal metacarpal island flap in the same period were set as group B.After one-year follow-up,the survival of finger web flaps,the recovery of hand function,the degree of pain and the satisfaction of family members were compared between the two groups.Results:After one year follow-up,all finger web flaps of the two groups survived(P>0.05).The FMA score of the two groups was higher than that before operation,and there was no significant difference between the two groups(P>0.05).The visual analogue scale(VAS)score of group B was lower than that of group A at 7 days and 1 month after operation(P<0.05).One year after operation,the aesthetic satisfaction of group B was higher than that of group A(P<0.05).Conclusion:Both dorsal metacarpal perforator sliding flap and dorsal metacarpal island flap can achieve an ideal survival rate of finger web flap and hand function improvement in the treatment of children with syndactyly,but the implementation of dorsal metacarpal island flap brings slight pain,and the satisfaction of family members with aesthetics is high,which has more advantages.