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find Author "胡雷鸣" 2 results
  • Reconstruction finger web with dorsal two wing-shaped advancement flap for the treatment of congenital syndactyly

    ObjectiveTo discuss the effectiveness of using dorsal two wing-shaped advancement flap to reconstruct finger web for treatment of congenital syndactyly.MethodsBetween August 2014 and August 2017, 30 cases of congenital syndactyly were treated, including 18 males and 12 females with an average age of 2.5 years (range, 1.5-5 years). Eight cases were of bilateral hands syndactyly and 22 cases of single hand syndactyly. There were 39 webs of syndactyly (including 1 case of syndactyly of middle finger, ring finger, and little finger). Among them, 11 webs were complete and 28 webs were incomplete. At the dorsum, a flap with V-shaped tip and two wing-shaped pedicle was designed and was just sewed up with an anchor-shaped incision at the palm. Distal end of fingers were separated by serrated flap and were sutured after removal of fatty tissue. In 11 cases with tight skin connection, the defect area at lateral and distal end of fingers was repaired by small pieces of full-thickness skin graft.ResultsAll the flaps survived completely after operation, and no flap necrosis occurred. The skin grafts on the distal side of the finger survived and the wound healed by first intension. All 30 cases were followed up 6-12 months, with an average of 9 months. Postoperative flexion and extension function of fingers were good, and the web depth and width were normal. At last follow-up, according to the Swanson et al. standard, 20 fingers were graded as excellent, 8 as good, and 2 as fair, with an excellent and good rate of 93.3%.ConclusionThe effectiveness of using dorsal two wing-shaped advancement flap to reconstruction finger web for treatment of congenital syndactyly is satisfactory.

    Release date:2019-01-25 09:40 Export PDF Favorites Scan
  • 踇甲皮瓣联合腓动脉穿支皮瓣游离移植再造拇指并修复足部供区 15 例

    目的总结应用踇甲皮瓣再造拇指及腓动脉穿支皮瓣游离移植修复足部供区的手术方法及临床效果。方法2016 年 6 月—2018 年 5 月,应用踇甲皮瓣联合腓动脉穿支皮瓣游离移植再造拇指并修复足部供区 15 例。男 10 例,女 5 例;年龄 21~48 岁,平均 34.6 岁。致伤原因:重物压砸伤 7 例,机器绞伤 5 例,电锯切割伤 3 例。Ⅰ度缺损 9 例,Ⅱ度缺损 6 例。入院至皮瓣手术时间 4~7 d,平均 5.2 d。结果术后踇甲皮瓣及腓动脉穿支皮瓣全部成活,切口均Ⅰ期愈合。患者均获随访,随访时间 8~24 个月,平均 16.4 个月。末次随访时,再造拇指指甲生长平整,有光泽,指腹饱满;足部皮瓣外形良好,颜色及质地接近受区。根据中华医学会手外科学会拇手指再造功能评定标准,获优 9 例、良 6 例;根据 Maryland 足功能评分标准,获优 10 例、良 5 例。患者行走步态正常,无跛行及疼痛不适。结论踇甲皮瓣修复拇指Ⅰ、Ⅱ度缺损,再造拇指可获得良好外观及功能;腓动脉穿支皮瓣具有血供可靠、血管恒定、易切取等优点,可有效修复足部供区。

    Release date:2020-06-15 02:43 Export PDF Favorites Scan
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