CAJ | 학술논문

目的：探讨应用三种皮瓣联合治疗小儿先天性并指畸形的临床效果。方法对15例小儿先天性并指畸形患者，采用三等分长矩形皮瓣再造指蹼、指间掌背侧锯齿对应皮瓣分指、指尖对应三角形皮瓣重建双侧甲皱、肘窝取全厚皮片行分指侧方植皮。结果15例小儿先天性并指畸形患者治疗后随访14～34个月，平均（16.93±2.72）个月，植皮及皮瓣全部成活，分指外形及功能良好，14名患儿家长表示满意。其中6例由于并指伴发畸形需进一步手术矫形，2例多个相邻并指需进一步行同侧其它并指分指术。结论采用三等分长矩形皮瓣再造指蹼、指间掌背侧锯齿对应皮瓣分指、指尖对应三角形皮瓣重建双侧甲皱操作简单，分指后手指外形良好，是修复小儿先天并指畸形的较好方法。
목적：탐토응용삼충피판연합치료소인선천성병지기형적림상효과。방법대15례소인선천성병지기형환자，채용삼등분장구형피판재조지복、지간장배측거치대응피판분지、지첨대응삼각형피판중건쌍측갑추、주와취전후피편행분지측방식피。결과15례소인선천성병지기형환자치료후수방14～34개월，평균（16.93±2.72）개월，식피급피판전부성활，분지외형급공능량호，14명환인가장표시만의。기중6례유우병지반발기형수진일보수술교형，2례다개상린병지수진일보행동측기타병지분지술。결론채용삼등분장구형피판재조지복、지간장배측거치대응피판분지、지첨대응삼각형피판중건쌍측갑추조작간단，분지후수지외형량호，시수복소인선천병지기형적교호방법。
Objective To explore the clinical effect of treating pediatric congenital syndactyly with combined application of three separate flaps. Methods For 15 cases of pediatric congenital syndactyly, long trisected rectangular flap over the dorsum was designed to reconstruct the web. Opposite interphalangeal serrated flaps over the dorsum and palmaris were taken to separate the syndactyly. Two triangle flaps of opposite directions from the distal pulp were designed to reconstruct the nail fold. Skin defects over the adjacent sides of the separated fingers were covered with full-thickness skin graft, which was taken from ipsilateral chelidon area. Results All cases were followed-up for 14 to 34 months, average (16.93± 2.72) months. Most parents were satisfied with the survived skin grafts and flaps and the great shape and function of the separated fingers. There were 8 patients who needed advanced surgeries, 6 cases for concomitant deformities and 2 cases for adjacent syndactyly. Conclusion It’s one of the best methods for treating congenital syndactyly that using long rectan-gular flap over the dorsum to reconstruct the web, opposite interphalangeal serrated flaps over the dorsum and palmaris to separate the syndactyly and two triangle flaps of opposite directions from the distal pulp to rebuild the nail fold.