摘要
目的 总结手部心曲挛缩畸形的病因、诊断及手术治疗方法。方法 1997年5月～2004年6月。对212例手部屈曲挛缩患昔。采取切除瘊痕、彻底松解孪缩、植皮、Z字成形术或双V-Y或四边VY成形术、掌背动脉皮瓣移位或髂腹股沟皮瓣移位修复继发创而。其中男163例．女49例，年龄3～61岁。左手85例，右手54例，双手73例。挛缩部位：手指117例，手掌32例．手掌合并手指63例。畸形原因：烧伤及爆炸伤29例，掌腱膜挛缩127例，车祸及机器挤压伤31例，电击伤5例，术后不正确外固定14例，其它6例。病程2～24个月。结果 术后149例获随访4～30个月。1例因术后强行出院，手指远端坏死。行残端成形术；7例发生二次屈曲挛缩畸形，其中3例术后皮肤坏死瘢痕愈合，2例患儿因惧怕疼痛功能锻炼欠佳．2例断层皮片移植者皮片挛缩；其余患者疗效满意。结论 明确挛缩病因及程度，选择合适的手术时机，彻底松解挛缩．正确的修复方法及术后早期、有效的功能锻炼，是取得良好疗效的重要因素。
Objective To investigate the etiology of the flexor eontracture of the hand, to diagnose and to explore its surgical treatment. Methods From May 1997 to June 2004, 212 cases of flexor contraction of the hand were treated with scar excision, thorough loosening the contracture, covering the secondary skin defects with free skin grafting, “Z”- plasty, douhlc “V-Y” plasty, transposition of the palmar dorsum flap of the hand and lilac inguinal flap. There were 163 males and 49 females, whose ages ranged from 3 to 61. There were 85 cases of left hands, 54 cases of right hands, and 73 cascsof both hands. Contracturc sites wcrc as follow： llTcases were in fingers, 32 cases located in palms and 63 cases were in both. Causcs of deformity were as follow： 29 cases derived from burn and explosion, 127 cases came from contracturc of palmar aponeurosis, 31 cases were because of traffic accident and machine extrusion, 5 cases for getting an electric shock, 11 cases for improper postoperative immobility, and 6 cases for other reasons. Course ofdiscaseslastcd for 2 to 21 months. Results 149cases were followed up for 4 to 30 months. One fingertip was in necrosis and ended in nub plasty because of inappropriate time to leave hospital. Flexion contracture recurred in 7 cases, skin necrosis occurred to 3 cases whose scars were healed in the end, poor restoration of function was observed in 2 children patients for lack of exercise, and 2 skins contractcd after frcc cut skin grafting. Others got satisfactory results. Conclusion Onee the pathogenesis and contrature factors arc clearly known, timing and correct surgical measures are chosen, thorough contracturc is loosened, and early postoperative exercises are performed, good effect will be achieved.
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2006年第1期33-36,共4页
Chinese Journal of Reparative and Reconstructive Surgery
关键词
手
届曲挛缩
修复
Hand Flexor eontracturc Repair
