应用双指腹皮瓣重建先天性全并指分指后的甲廓

RECONSTRUCTION OF NAIL FOLDS BY DOUBLE PULP FLAP IN CONGENITAL COMPLETE SYNDACTYLY RELEASE

目的 介绍一种先天性全并指分指时重建甲廓的手术方法。方法 对 15例先天性全并指患者在分指时 ,利用共有末节手指掌侧皮肤形成宽、窄两块皮瓣覆盖分开后裸露的甲缘 ,重建甲廓。结果 所有皮瓣均成活 ,30个重建的甲廓中有 2 1个外观满意 ,2个由宽皮瓣、7个由窄皮瓣重建者较正常的稍小。术后指腹丰满、无指甲扭曲。结论 应用双指腹皮瓣重建甲廓治疗先天性全并指可一次完成 ,效果满意 。

Objective To introduce a surgical approach for reconstruction of nail folds in congenital complete syndactyly release. Methods A narrow flap and a broad flap were raised on the common distal phalanx to cover the denuded nail edge in 30 fingers of 15 cases whose webs were separated. Results All of the flaps were successfully transferred and survived. The reconstructed nail folds had satisfied figure in 21 out of 30 fingers. The nail folds in the other 9 fingers, covered by a broad flap in 2 fingers and by a narrow flap in 7 fingers, were a little smaller than normal. All of the 30 fingers had normal fullness of pulp and no twisty nails. Conclusion The reconstruction of nail folds by double pulp flap can be performed with a one stage technique, and the outcome is satisfactory, which make it as a good surgical approach to reconstruct nail folds in congenital complete syndactyly release.