Objective To discuss the thumb web anomalies with Poland's syndrome and the reconstruction strategies. Methods From June 2013 to July 2018, 46 cases of Poland's syndrome with the thumb web anomalies were classified into four conditons, linear contracture (14 cases), non-linear contracture (13cases), syndactyly (17 cases) and contracture with a empty first web (2 cases), which were reconstructed by Z plasty, direct incision with free skin grafting, syndactyly release and transfer flap from the dorsum of the index respectively. Results All the thumb webs were reconstructed with well blood supply. 84.7% cases were excellent or good after quality evaluation, and 10.9% for acceptable cases, 4.4% for unacceptable cases. Subjective functional accessment of the thumb showed 37 cases had significant improvement. Palmar abduction of 46 patients reached 45°. Conclusion Deformities of the thumb web for patients with Poland's syndrome needs early intervention, based on the classifications of the anomalies and the result is always good.%目的 探讨Poland综合征拇指蹼畸形表现及重建策略.方法 2013年6月-2018年7月共收治46例Poland综合征拇指蹼异常患者,将他们分为四型:拇指蹼线状挛缩14例,拇指蹼非线性挛缩13例,拇示指并指17例,拇指蹼挛缩伴内容物缺乏2例.分别行拇指蹼开大,"Z "字成形术,直接梭形切开游离植皮术,拇示指并指分指术,示指背侧转移皮瓣.结果 术后拇指蹼血运良好,质量评估结果:优良84.7%,可10.9%,差4.4%.拇指功能主观评估显示37例获得显著的改善.拇指被动掌侧外展活动度均大于45°.结论 Poland综合征拇指蹼重建需早期进行,根据畸形的分型行相应的矫形手术,治疗效果明确.
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