Abstract:Objective To introduce a new method of releasing syndactyly with the Ilizarov external fixator.Methods From Janurary 2016 to Janurary 2020,7 cases of cutaneous syndactyly were treated with the Ilizarov external fixator in our hospital.There were 4 males and 3 females,with an average age of (3.0±1.6)years (range:1.5~6.0 years).There were 2 cases on the left side and 5 cases on the right side.Mini Ilizarov external fixators were used to stretch the skin between the fingers(toes).The extension started 3 days after the operation and lasted for 1~2 mm every day.The wrist was fixed with brace.When sufficient skin was obtained,the “Z” shape flap plasty was performed.Follow-up was conducted at 1,3,6 and 10 months after the operation.Doctors evaluated the appearance of the children's fingers,scar quality,finger web scar,active range of motion,etc.Vancouver score was used to evaluate the scar condition of the wound.Parents assessed pain,appearance,and finger function based on visual analogue scale.Results 7 cases had been followed up with an average time of (12.0±2.3) months,(range:10~16 months).After 16~27 days of skin stretching with mini Ilizarov external fixator,more than 1.5 cm skin could be obtained.Free skin grafting was no longer needed in releasing operation.There was no infection,falling off of external fixator,skin necrosis,scar contracture and other complications during the treatment.The appearance and function of the released fingers were satisfactory.Vancouver score was 0~2,with an average of (0.6±0.8).The average scores of pigmentation,Pliability and web height were (0.4±0.5),(0.1±0.3) and (0.3±0.5).The VAS score provided by parents was 1~4,with an average of (2.0±1.2),appearance was (0.7±0.8)(range:0~2),function was (0.4±0.5)points (range:0~1).Conclusion The Ilizarov external fixator designed according to Ilizarov's tension stress law has the advantages of simple operation,convenient nursing and had abtained sufficient skin source.It does not affect the blood supply of the released fingers and does not require autografts.It is an effective method to treat simple syndactyly.
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