摘要目的 探讨应用指尖舌形皮瓣互换重建侧甲襞联合“U”形皮瓣重建指蹼治疗先天性并指畸形的疗效.方法 自2005年1月至2011年8月收治28例先天性并指畸形患者,术前设计指尖舌形皮瓣重建甲侧襞,掌指关节之间背侧设计“U”形皮瓣重建指蹼,并指之间掌、背侧设计“Z”形切口,切取皮瓣并进行分指矫形术,手指侧方剩余创面行全厚皮片植皮修复,适当加压包扎.术后给予抗生素预防感染,拆线后指导患者进行功能锻炼.结果 28例并指重建的指蹼接近正常,甲侧襞重建满意,无一例并发末节指骨外露,外观满意,手指伸屈、内收、外展功能较术前明显改善,效果满意.结论 应用指尖舌形皮瓣互换重建侧甲襞联合“U”形皮瓣重建指蹼治疗并指畸形,术后外观功能恢复良好,是先天性并指畸形矫正术的良好方式之一.

abstractsObjective To investigate the efficacy of lateral nailfold reconstruction with fingertip tongueshaped flap and finger web reconstruction with U-shaped flap in syndactyly correction.Methods From January 2005 to August 2011,28 eases of congenital syndaetyly were treated.Zig-zag incisions were made on both the palmar and dorsal aspects of the fused fingers to separate the fingers.The lateral nailfold was reconstructed with fingertip tongue-shaped flap.Meanwhile,a U-shaped flap was designed between the dorsal metacarpophalangeal joints to form the finger web.The remainder of the lateral sides of the separated fingers was covered with fullthickness skin graft.Light compression dressing and postoperative prophylactie antibiotics were applied.Functional exercises were initiated upon suture removal.Results The finger web in all 28 cases was close to normal.Lateral nailfold reconstruction was satisfactory.There was no exposed distal phalanx.The appearance was good.Significant improvement was seen in finger flexion/extension and adduction/abduction.The overall results were satisfactory.Conclusion Lateral nailfold reconstruction with fingertip tongue-shaped flap and finger web reconstruction with U-shaped tlap is a good option in syndactyly correction.It leads to satisfactory restoration of both appearance and function.