摘要目的 探讨对偶交叉梯形皮瓣和指侧方皮瓣治疗手指瘢痕挛缩屈曲畸形的临床效果、适应证和注意事项.方法 自2014年2月至2016年10月我们共收治l4例25指手指瘢痕挛缩屈曲畸形患者.按瘢痕挛缩线延伸范围分别采用对偶交叉梯形皮瓣(A组7例12指)和手指侧方皮瓣(B组7例13指)治疗.比较两种皮瓣的修复范围、感染及坏死率、患指关节总活动度(TAM)、瘢痕挛缩线延长率及是否再次手术矫形.结果 术后14例25指皮瓣全部存活,A组皮瓣修复范围达到远指间关节水平,B组达到近指间关节水平.两组均未出现因瘢痕挛缩复发导致再次手术,但B组患者对手术效果满意度较A组低.结论 对偶交叉梯形皮瓣血供可靠,手术操作简单,修复范围达到远指间关节水平,允许关节早期活动,是一种更为理想的治疗跨关节瘢痕挛缩屈曲畸形的方法.

abstractsObjective To investigate the clinical efficacy,indications and precautions of dual intersecting trapezoid flaps and laterodigital flaps in the treatment of finger flexion deformity of scar contracture.Methods From February 2014 to October 2016,14 patients (25 fingers) with finger flexion deformity of scar contracture were treated.According to the extension of scar contracture line,dual intersecting trapezoid flaps were used in 7 cases (12 fingers) (group A) and laterodigital flaps were used in 7 cases (13 fingers) (group B).The repair range,infection and necrosis rate,total active motion of inured finger (TAM),extension rate of scar contracture line and reoperation were compared between the two groups.Results All the flaps survived uneventfully.The repair range of group A reached the level of DIP and group B reached the level of PIP.There was no reoperation due to recurrence of scar contracture in both groups,but the satisfaction of group B was lower than that of group A.Conclusion The dual intersecting trapezoid flaps have reliable blood supply and the operation is simple,the repair range of which can reach the level of DIP.They can allow early joint movement.It is a more ideal method for the treatment of finger flexion deformity of trans-articular scar contracture.