Hynes S L, Harvey I, Thomas K, Copeland J, Borschel G H
Division of Plastic and Reconstructive Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada.
Department of Plastic and Reconstructive Surgery, Women's and Children's Hospital, North Adelaide, South Australia, Australia.
J Hand Surg Eur Vol. 2015 Jul;40(6):625-32. doi: 10.1177/1753193414541222. Epub 2014 Jul 8.
We describe the CT angiography protocol and surgical technique utilized at our institution for single-stage release of adjacent web-spaces in non-Apert syndactyly. In a series of seven consecutive hands we analyse syndactyly anatomy, CT angiographic findings, operative details, and complications. Outcomes were assessed with a functional activity evaluation, range of motion, and a parental visual analogue scale. Seven affected hands in four patients underwent single-stage release of adjacent webspaces. In all cases, the CT angiogram correctly predicted the presence of at least one artery supplying each digit. There were no cases of digital ischemia or loss. Angiographically guided, single-stage release of adjacent webspaces is technically feasible and benefits patients by reducing the number of surgical stages and allowing complete release to be achieved at an earlier age compared with the standard multi-stage approach.
IV.
我们描述了我们机构用于非Apert并指畸形中相邻蹼间隙单阶段松解的CT血管造影方案和手术技术。在连续的七只手中，我们分析了并指畸形的解剖结构、CT血管造影结果、手术细节和并发症。通过功能活动评估、活动范围和家长视觉模拟评分来评估结果。四名患者的七只患手接受了相邻蹼间隙的单阶段松解。在所有病例中，CT血管造影均正确预测了至少有一条动脉供应每个手指。没有手指缺血或缺失的病例。在血管造影引导下，相邻蹼间隙的单阶段松解在技术上是可行的，与标准的多阶段方法相比，可减少手术阶段数量，并使患者能够在更早的年龄实现完全松解，从而使患者受益。
IV。
