指背五边形皮瓣重建指蹼治疗先天性并指的疗效分析

Application of dorsal pentagonal flap for reconstruction of the web space in congenital syndactyly

目的探讨采用指背五边形皮瓣重建指蹼治疗先天性并指的临床疗效。方法2007年10月至2009年8月利用指背五边形皮瓣重建指蹼治疗先天性并指的患者10例，并进行了随访，采用客观的手指功能检查、指蹼形态观察以及患者主观满意度评价手术效果。结果10例患者均获随访，随访时间4～25个月，平均15个月。各例指蹼外观均接近正常指蹼，并指分指后手指被动屈伸功能正常，外展度30°～45°。指蹼爬移率和再次矫形率均为0，患者家属对手术效果满意。结论采用指背五边形皮瓣重建指蹼治疗先天性并指，术后皮瓣成活率高，指蹼外观功能接近正常指蹼，再次矫形率低，皮瓣设计及手术操作相对简单，便于掌握。

Objective To investigate the therapeutic effect of dorsal pentagonal flap for reconstruction of the web space in congenital syndactyly. Methods From October 2007 to August 2009, 10 patients with congenital syndactyly were treated with dorsal pentagonal flap for web space reconstruction. During the follow-up period, the patients underwent finger functional assessment and web space appearance examination. The satisfactory rate of patients was also investigated. Results 10 patients with 17 reconstructed web spaces were followed up for 4-25 months（ median, 15 months）. Normal passive flexion and extension of fingers were achieved with good cosmetic result at web space. The abduction angle of fingers ranged from 30° to 45°. No web creep occurred and no secondary procedures were required. All the parents of the patients were satisfied with the results. Conclusions Web space reconstruction with dorsal pentagonal flap is easily performed with reliable blood supply and low re-operated rate. The cosmetic and functional result is satisfactory.