Gramcko's Triangular Flap for Separation of Syndactyly with Terminal Bone Bridge

使用Gramcko三角形皮瓣於分離複雜性併指畸形之末端指骨融合之治療

劉國威(Kwork-Wai Lau) ； 王家儀(Chia-Yi Wang) ； 陳杰峰(Chieh-Feng Chen)

《中華民國整形外科醫學會雜誌》 11卷4期 (2002/12) Pp. 298-303

https://doi.org/10.7096/JPSA.200212.0298

摘要

治療複雜性併指畸形時常引起融合處之指骨外露，而覆蓋外露指骨的手術方法有不少被提出討論。如Marumo，Johansson等人都提出其治療的方法，綜合這些方法都是方法複雜，在小孩上固定皮瓣不易，而且須接受多次手術才可完成。本文中三例複雜性併指畸形而末端指骨融合的病例中，共有五隻手受影響，而利用Gramcko提出的三角形皮瓣來達成分離的目的指蹼共有七處，用這塊皮瓣來重建的目的主要因為該法手術設計簡單，術後合乎外形美觀及功能良好的需求，且只需一次手術就能完成，經追上述病例二年至六年時間，其間指甲外側組織美觀自然，且未有指甲溝炎發生，其結果良好，是提供給分離複雜性併指畸形的理想手術方法之一。

並列摘要

The treatment of complex and complicated syndactyly with regards to the coverage of exposed phalanges is still a disputable problem up to the present. Thus, a lot of procedures are suggested such as to use abdominal flap and using thenar flap to cover wound after separation of phalanges. The abovementioned procedures can separate the osseous fusion of the distal phalanges but the operations are tedious and complicated and need to be done in two stages.
We reported three cases of complex syndactyly with 5 hands involved, total seven web spaces were separated in this article. We use the Gramcko's procedure by designing a triangular skin flap to cover the wound after separation of the osseous fusion and all cases were done in one stage operation with acceptable functional and cosmetic results.

並列關鍵字

complex syndactyly ； acrosyndactyly ； Gramcko's triangular flap ； distal phalangeal fusion