虎口挛缩的手术治疗

Therapy of Thumb Web Contracture

目的探讨虎口挛缩的治疗方法。方法对1990年6月～2006年12月42例虎口挛缩患者,根据挛缩严重程度分别采用保留真皮下血管网的全层皮肤移植、"Z"型延长术、腹部带蒂皮瓣(皮管)及上肢交臂皮瓣修复治疗、第二掌指背侧岛状皮瓣修复等方法进行修复。结果42例患者皮瓣均成活。术后随访6月～3年,原虎口挛缩畸形都得到了完全或接近正常的矫正,术前虎口夹角20～30度,术后夹角均达到了50～70度,虎口外形良好,可完成拇指外展对掌功能。结论根据患者虎口畸形程度选择不同的手术方式是治疗虎口挛缩的有效方法。

Objective To study the therapy of thumb web contracture. Methods From June 1990 to December 2006 the clinical materials of 42 thumb web cases were treated with preserved subcutaneous vascular network skin graft, ＂Z＂ shaped lengthening, abdominal pedicled skin flap,cross-arm pedicled skin flap and the back island flap of the second plam finger for reconstruction based on severity of thumb web contracture. Results All flaps survived, follow-up（6-36） months survey of the patients ＇after the operation showed the thum web conracture cases were totally reconstrcuted or recovered to normal state. Bfeore operation the thumb web angle was 20 to 30 degree, and after operation the angle was 50 to 70 degree. Thumb web had good appearance and can acomplish opponens Function. Conclusion Different operation methods shoud be applied according to the severity of the tumb web of patients, which is an efficient way to treat thumb web consracture.