反M—V皮瓣指蹼重建术在并指畸形矫正中的应用

Application of finger web reconstruction with contra M-V skin flap in syndactyly correction

目的介绍一种反M—V皮瓣法指蹼成形术在并指畸形矫正中的应用及临床效果。方法应用反M—V皮瓣指蹼重建术治疗先天性并指畸形，在指蹼掌侧做V形皮瓣，掌背侧做有中线穿经的V形皮瓣，切开后形成M形皮瓣，将掌侧V瓣插入掌背M瓣内。结果自2001年3月至2009年4月，对18例患者的33处并指畸彤重建指蹼，术后外观满意。随访6个月至3年，再造指蹼的深度和宽度与正常侧手指接近，术后指间的活动度均可达30。，手指的屈伸功能正常。其中，1例M瓣远端的指蹼皮瓣尖端糜烂坏死，2例指蹼皮瓣边缘的植皮皮片出现部分表皮坏死，经换药后痊愈，其余成形的指蹼均I期愈合。结论反M—V皮瓣指蹼重建术是并指畸形中指蹼再造的理想方法之一。

Objective To explore the application of finger web reconstruction with contra M-V skin flap in syndactyly correction and its clinical effect. Methods The patients with syndaetyly were corrected by finger web reconstruction with contra M-V skin flap. V-shaped skin flap was formed on palm side of finger web, while the V-shaped skin flap with central line through was made on the palm back which was then cut to form the Mshaped flap. The V-shaped flap was inserted into the M-shaped flap. Results From March 2001 to April 2009, 18 cases with 33 syndactyly were performed the operation mentioned above. After 6 - 36 months follow-up, the depth and width of reconstructed finger web were similar to the normal fingers, the interdigital activity could reach 30° postoperatively with normal extension and flexion function. All the reconstructed fingers healed primarily except for 1 case with erosion and necrosis appeared in the pointed end of the M-shaped flap and 2 cases with epidermal necrolysis in the margin of the grafted flaps which healed after changing dressings. Conclusion The finger web reconstruction with contra M-V skin flap is an ideal method for the reconstruction of syydactyly.