指蹼上移术治疗先天性短并指畸形

Transposition Upward of Web Space Flap for Correction of Congenital Brachy-syndactyly

目的研究先天性短并指畸形的手术治疗方法。方法观察40例正常人的指蹼结构,并以此为标准,设计了指蹼上移术,即在指蹼掌、背侧分别作V字切口,将整个指蹼做成1个指蹼皮瓣,向上推移至标准位置的手术方法。对1例女性患者的双手第2～4指蹼共6个指蹼行指蹼皮瓣上移术。结果术后随访1年,双手第2～4指蹼位置较术前分别上移了8、13、4mm,达标准位置,并保留了指蹼原来的正常形态,手指与手掌长度比例协调美观,活动自如。结论指蹼皮瓣上移术能在上移指蹼的同时保留指蹼原来的正常形态,达到分指、延长手指从而治疗短并指畸形的目的。

Objective To study surgical management for correction of congenital brachy-syndactyly.Methods The shape of normal web space was observed in 40 healthy persons.According to this,web space flap was designed and advanced upward. V-shaped incision was performed at the volar and dorsal aspect of the web space to form one web flap.Then the flap was advanced upward to the preplanned position.A 21-year-old female received the treatment of Transposition Upward of web space flap in the second,third and fourth web spaces of both hands.Results One year later,the second,third,and fouth web spaces in both hands advanced 8,13,4 mm upward with normal appearance,reaching standard position.The length of the finger and palm was well-proportioned.The fingers moved freely.Conclusion The transposition upward of web space flaps can be used to seperate and lengthen fingers in the treatment of brachy-syndactyly,while keeping the original appearance of web space.