Kvernmo Hebe Désirée, Haugstvedt Jan-Ragnar
Section for Upper Extremity- and Microsurgery, Department of Orthopaedics, Oslo University Hospital, Norway.
Tidsskr Nor Laegeforen. 2013 Aug 20;133(15):1591-5. doi: 10.4045/tidsskr.13.0147.
Syndactyly or webbed fingers is one of the most common congenital malformations of the upper extremities, but it comprises few new cases annually. The purpose of treatment is to enhance hand function.
The article is based on current text books and literature searches in PubMed as well as the authors' clinical experience within this field.
The purpose of surgical treatment is to separate the fingers and reconstruct a webspace. It is difficult to indicate exact treatment results because of large variations in the extent of the deformity. For syndactyly involving only soft tissue (simple syndactyly), a good functional result is achieved with a less than 10% risk of complications. Syndactyly where also the bones have fused (complex syndactyly) or where there is additional bone formation between two digital rays (complicated syndactyly), gives a poorer functional outcome and a higher risk of complications. Gradual stretching of the tissue using a distraction device enables separation of fingers one was previously reluctant to separate.
It should be possible to expect safe separation with a good and independent function of the fingers with surgical treatment. The parents should be informed that the surgical treatment is a reconstructive procedure that may require secondary corrections.
并指或指间蹼是上肢最常见的先天性畸形之一，但每年新增病例较少。治疗目的是改善手部功能。
本文基于当前的教科书、在PubMed上的文献检索以及作者在该领域的临床经验。
手术治疗的目的是分离手指并重建指蹼间隙。由于畸形程度差异很大，难以确切说明治疗效果。对于仅累及软组织的并指（单纯性并指），功能恢复良好，并发症风险低于10%。骨骼也融合的并指（复杂性并指）或两指骨间有额外骨形成的并指（复杂性并指），功能恢复较差，并发症风险较高。使用牵张装置逐渐拉伸组织可使之前难以分离的手指得以分开。
手术治疗应能实现安全分离，使手指具有良好且独立的功能。应告知家长，手术治疗是一种重建手术，可能需要二次矫正。
