低龄儿童先天性并指畸形的整复治疗

Treatment of infant hand congenital syndactyly

目的:探讨低龄儿童先天性并指畸形的治疗时机及手术方法。方法:选择3岁以下的患儿38例,采用锯齿状皮瓣转移分离并指,指背、掌侧矩形或三角形皮瓣成形指蹼,皮肤缺损区全厚植皮的术式,术后小夹板加强固定术指。结果:本组38例除10例出现皮肤部分表皮坏死,经换药愈合外,其余创面一期愈合;9例出现瘢痕孪缩:7例经术指小夹板固定及结合局部注射糖皮质激素治疗后缓解,1例因术指屈曲明显而再次行瘢痕松解术,1例指侧瘢痕挛缩,轻度侧向弯曲,未行处理。随访6月～2年,除未处理的1例外,37例外形、功能良好,指蹼深度、宽度接近正常。结论:低龄儿童先天性并指畸形的整复在临床上是可行的。

Objective：To study the technique of treatment of infant hand congenital syndactyly. Methods：All cases were from 6 months to 2 years old .In these cases, the fingers were separated by using the serrated flap and new web were created deeply and widely by using rectangle or triangle inter-phalangeal flap at dorsal and palmaris. The skin-defected areas were covered with full-thickness skin grafts and the fingers were fixed using small splints. Results：All 38 cases were primary healing except that partial necrosis of skin graft in 10 cases which were healed after dressing change. The scar of 7 Cases were relieved by using small splints at night and glucocorticoid injection treatment. 1 case which finger was bent because of scar was operated again and another one had not any management. Followed up 6 months ～2 years,37 cases had good features and functions except one case without dealed. Conclusion：h is feasible that treatment of hand congenital syndactyly durying infancy.