CAJ | 학술논문

目的探讨掌背穿支皮瓣滑移术在先天性并指畸形指蹼重建中的应用.方法在解剖学研究的基础上根据分指后指蹼皮肤缺损面积及创面形状,在手背相应掌骨间设计相应大小及形状的皮下穿支蒂掌背皮瓣(皮瓣四周切开而皮下不游离),并于2007年5月至2012年11月,修复重建先天性并指畸形15例23侧28个指蹼.结果 28个皮瓣全部成活,皮瓣最大面积3 cm×2 cm,最小面积1.5 cm×1.0 cm.术后14例22侧26个皮瓣获10 ～22个月随访,平均14.5个月,患者指蹼大小适中,外形正常,掌指关节活动良好;指蹼两点辨距觉9～13 mm,平均11 mm.根据Swanson手功能的评定标准,对分指后的运动和感觉功能进行评定:优18个,良8个,可2个,优良率达92.6％.结论掌背穿支皮瓣滑移术重建指蹼,具有手术简便安全、重建指蹼外形美观、功能好等优点,是先天性并指畸形指蹼重建的较好方法之一.
목적 탐토장배천지피판활이술재선천성병지기형지복중건중적응용.방법 재해부학연구적기출상근거분지후지복피부결손면적급창면형상,재수배상응장골간설계상응대소급형상적피하천지체장배피판(피판사주절개이피하불유리),병우2007년5월지2012년11월,수복중건선천성병지기형15례23측28개지복.결과 28개피판전부성활,피판최대면적3 cm×2 cm,최소면적1.5 cm×1.0 cm.술후14례22측26개피판획10 ～22개월수방,평균14.5개월,환자지복대소괄중,외형정상,장지관절활동량호;지복량점변거각9～13 mm,평균11 mm.근거Swanson수공능적평정표준,대분지후적운동화감각공능진행평정:우18개,량8개,가2개,우량솔체92.6％.결론 장배천지피판활이술중건지복,구유수술간편안전、중건지복외형미관、공능호등우점,시선천성병지기형지복중건적교호방법지일.
Objective To investigate the application of the dorsal metacarpal perforator sliding flap for web-space reconstruction in congenital syndactyly.Methods According to the size and shape of skin defect at the web space after division operation of syndactyly,the corresponding intermetacarpal perforator sliding flap was designed.The edge of the flap was cut off,but its underlying tissue was not dissected.From May 2007 to November 2012,28 web-spaces in 15 patients with syndactyly (10 male and 5 female) were reconstructed.Results All the 28 flaps survived completely.The flap size ranged from 3 cm ×2 cm to 1.5 cm×l.0 cm.14 cases with 26 flaps were followed up for 10-22 months (average,14.5 month).The reconstructed web spaces had normal appearance and movement range.The 2-point discrimination distance was 9-13 mm(average,11 mm).According to the Swanson Standard,18 fingers were graded as excellent,8 as good and 2 as fair (excellent and good,92.6％,26/28).Conclusions Reconstruction of web-space in syndactyly with the dorsal metacarpal perforator flap has the advantages of easy handling,good cosmetic and functional results.