先天性并指畸形手术并发症防治体会

Prevention and Treatment of Postoperative Complications in Congenital Syndactyly Deformity

目的探讨先天性并指术后常见并发症产生原因及防治方法。方法我科1998年6月～2011年5月收治先天性并指术后并发症21例,主要并发症为分指屈曲挛缩和指蹼粘连爬升。再次手术采用植皮或皮瓣松解瘢痕挛缩,重建加深指蹼成形。结果术后随访时间6～12个月,无感染和植皮坏死。患指外形和功能均有较大程度改善,未再出现明显屈曲挛缩和指蹼爬升粘连。手指功能优5例,良12例,可4例,优良率81.0%。结论掌握正确手术时机,进行适宜的指蹼和指端成形设计,术中精细操作,术后锻炼得当,会显著减少先天性并指的术后并发症。

Objective To explore the reasons for postoperative complications in congenital syndactyly deformity and its prevention.Methods There were 21 cases of congenital and postoperative complications referred to as flexion contracture or the subwebbed adhesion climb;skin graft or flap surgery was used to release scar contracture;re webbed deepening refers to reshape.Results The results were followed up for 6-12 months,and there was no infection and graft necrosis.Form and function had a greater degree of improvement,which involved no further significant flexion contracture or webbed climbing adhesion.The functions of fingers were excellent in 5 cases,good in 12 cases,and fair in 4 case.Good and excellent rate was 81.0%.Conclusion To know the exact timing of surgery,the appropriate design of webbed finger forming and shaping,fine operation,preoperative and postoperative exercise,will greatly reduce the postoperative complications.