15例Poland综合征并指畸形修复

商浩 张放 罗鹏远 任强 甄磊

[摘要]目的：探讨一种Poland综合征并指畸形修复的新方法和疗效。方法：2015年8月-2019年10月利用掌背六边形皮瓣一期重建指蹼治疗Poland综合征并指畸形15例患儿，19个并指，均不需要植皮。结果：19个并指均一期重建指蹼闭合创面，均未植皮，术后无血肿、感染及皮瓣坏死等并发症。随访3～48个月，平均18个月，其中1例出现指蹼爬移，未发现屈曲挛缩现象，所有手指均无明显瘢痕增生，屈曲及外展功能良好。结论：掌背六边形皮瓣重建指蹼，不需要植皮，操作简单，皮瓣成活率高，临床疗效满意。

[关键词]Poland综合征;并指;外科皮瓣;六边形皮瓣;指蹼;畸形修复

[中图分类号]R622    [文献标志码]A    [文章编号]1008-6455（2021）07-0001-04

Treatment of 15 Cases of Poland Syndrome with Syndactyly

SHANG Hao，ZHANG Fang，LUO Peng-yuan，REN Qiang，ZHEN Lei

（Department of Traumatology，Hebei Province Childrens Hospital，Shijiazhuang 050031，Hebei，China）

Abstract： Objective  To explore a new method and clinical effect for treatment Poland syndrome with syndactyly. Methods  From August 2015 to October 2019， a dorsal hexagonal flap was used to reconstruct the finger web for 15 cases of Poland syndrome with syndactyly， and 19 webs without skin grafts. Results  All 19 webs were reconstructed in same procedure and lateral sides of the fingers were all closed with flaps without skin grafts.There were no complications such as hematoma， infection or flap necrosis. The average follow-up time was 18 months （range， 3 months to 48 months）. One of the 19 webs developed web creep. No patients developed flexion contractures. All fingers had no obvious scar， and the flexion and abduction function were good. Conclusion  The dorsal hexagonal flap does not require skin grafting. The operation is simple， and the survival rate of the flap is high. The clinical effect is satisfactory.

Key words： Poland syndrome; syndactyly; surgical flap; hexagonal flap; finger web; deformity repair

Poland综合征是一种少见的先天性畸形，又称胸大肌缺如短指畸形。其临床特点为胸大、小肌缺如，肋骨缺如，可同时合并有手指缺如、短指并指畸形、腕骨發育不全、漏斗胸及脊柱畸形。2015年8月-2019年10月，笔者科室共收治了Poland综合征15例，均为单侧手部短指并指畸形，均应用掌背六边形皮瓣一期重建指蹼矫正，取得了良好的效果。

1  资料和方法

1.1 一般资料：本组男9例，女6例;年龄12～39个月，平均20.6个月;左手3例，右手12例;中、环指并指8例，示、中指并指4例，示、中、环两处均为并指2例，示、中、环及小指全部并指1例，共19个并指，均为单纯性并指，未发现骨性并指;13个指蹼完全性并指，6个为不完全性并指。所有患者均应用掌背侧六边形皮瓣一期重建指蹼行并指分指手术。

1.2 手术方法：所有患儿手术均在全麻下进行，上臂应用气压止血带。……