手部先天性并指畸形的手术治疗进展

Progress in the studies on surgical treatment of congenital syndactyly of the hand

先天性并指是最常见的手部先天畸形,通常是由指蹼间隙形成障碍和手指分化异常导致的。从手指远端至正常指蹼水平的指间细胞凋亡-细胞外基质降解和手指间组织分化,是正常指间空间形成的基础,以上两个过程的发生及进行出现异常都可能会导致不同类型的并指畸形[1],如完全性并指和不完全性并指,

Congenital syndactyly is one of the most common congenital hand anomalies, and syndactyly release is one of the most common procedures in surgery of congenital hand diseases. The goal of syndactyly release is to create a web space close to normal in order to improve the appearance and function of the finger and incur the minimum number of long-term morbidity. This article reviews the domestic and foreign literatures published in recent years and summarizes the progress in the treatment of congenital syndactyly.（ 1） Operation timing of syndactyly release. Different choices for operation timing have been proposed according to the types of the congenital syndactyly and the surgical techniques applied. Technique for single-stage, more than 2-digit release has obvious advantages with preoperative delineation of the vascular anatomy of the hand.（ 2） Web space reconstruction is the most important stage in the surgical treatment of syndactyly, and several dorsal metacarpal flaps have been described for syndactyly correction in recent years. To evaluate and compare the results of different dorsal flap techniques, postoperative complications and web-space appearance have been taken into account.（ 3） Separation of the digits and defect covering. The use of skin grafts is time consuming, and a variety of dorsal flaps and other techniques have been used to avoid complications related to skin grafts. And it is very necessary to emphasize and control the indications in the application of these methods.