V-M 성형술을 이용한 지간구축 및 합지증의 교정 임상례

Clinical Experiences about Correction of Web Space Contracture and Syndactyly using V-M Plasty

  • 김의식 (전남대학교 의과대학 성형외과학교실) ;
  • 박상렬 (전남대학교 의과대학 성형외과학교실) ;
  • 황재하 (전남대학교 의과대학 성형외과학교실) ;
  • 김광석 (전남대학교 의과대학 성형외과학교실) ;
  • 이삼용 (전남대학교 의과대학 성형외과학교실)
  • Kim, Eui-Sik (Department of Plastic and Reconstructive Surgery, Chonnam National University Medical School) ;
  • Park, Sang-Ryul (Department of Plastic and Reconstructive Surgery, Chonnam National University Medical School) ;
  • Hwang, Jae-Ha (Department of Plastic and Reconstructive Surgery, Chonnam National University Medical School) ;
  • Kim, Kwang-Seog (Department of Plastic and Reconstructive Surgery, Chonnam National University Medical School) ;
  • Lee, Sam-Yong (Department of Plastic and Reconstructive Surgery, Chonnam National University Medical School)
  • 투고 : 2009.09.01
  • 심사 : 2009.11.16
  • 발행 : 2010.01.10

초록

Purpose: The loss of web space is caused by congenital syndactyly or acquired burn injury, trauma or surgery. Numerous surgical procedures have been described for restoration of the web space. Local flaps are usually preferred because of the easiness to perform and tolerable postoperative outcome. Among the various local flaps, the authors introduce V-M plasty for correction of web space contracture and syndactyly. Method: From March 2007 to Jun 2008, 4 patients underwent V-M plasty for correction of web space contracture and syndactyly. V-M plasty consists of 3 distinct triangular flaps. One triangular flap is designed next to the web region on the dorsal site of the hand, whereas the remaining 2 triangular flaps are placed on the volar site. The dorsal triangular flap is then placed between the volar adjacent triangular flaps. At the end of the operation, the involved fingers or toes are positioned in abduction to avoid kinking of the triangular flaps. Result: All the patients gained web functions with good esthetic appearance without any recurrence or complications. Mean follow-up was 8 months. Conclusion: V-M plasty is a safe, easy and rapid procedure to design and apply by using local tissues without the needs for a skin graft or risk of linear scarring and recurrence. The authors advise this versatile technique both in primary and recurrent cases of web space contracture and syndactyly.

키워드

참고문헌

  1. Tan O, Atik B, Ergen D: Versatile use of the VM-Plasty for reconstruction of the Web Space. Ann Plast Surg 55: 623, 2005 https://doi.org/10.1097/01.sap.0000181651.66907.8f
  2. Alexander JW, Ma cmillan BG, Martel L: Correction of postburn syndactyly: An analysis of children with introduction of the VM-plasty and postoperative pressure inserts. Plast Reconstr Surg 70: 345, 1982 https://doi.org/10.1097/00006534-198209000-00009
  3. Woolf RM, Broadbent TR: The four-flap Z-plasty. Plast Reconstr Surg 49: 48, 1972 https://doi.org/10.1097/00006534-197201000-00009
  4. Shinya K: Dancing girl flap: A new flap suitable for web release. Ann Plast Surg 43: 618, 1999 https://doi.org/10.1097/00000637-199912000-00007
  5. Ostrowski DM, Feagin CA, Gould JS: A three-flap web-plasty for release of short congenital syndactyly and dorsal adduction contracture. J Hand Surg 16A: 634, 1991
  6. Savaci N, Hosnuter M, Tosun Z: Use of reverse triangular V-Y flaps to create a web space in Syndactyly. Ann Plast Surg 42: 540, 1999 https://doi.org/10.1097/00000637-199905000-00013
  7. El Kollali R, Ghoneim I, Azemi MA: V-N plasty for the release of severe postburn contractures. J Plast Reconstr Aesthet Surg 59: 1424, 2006 https://doi.org/10.1016/j.bjps.2006.01.043
  8. Onishi K, Maruyama Y, Chang CC: Further application of VM-plasty. Ann Plast Surg 18: 480, 1987 https://doi.org/10.1097/00000637-198706000-00003
  9. Kong BT, Suh IS, Ha JW, Oh SJ: Clinical study on post-burn syndactyly with interdigital scar contracture. J Korean Soc Plast Reconstr Surg 18: 735, 1991
  10. Choi TH, Son DG, Han K: Classification and reconstructive strategies of first web space contracture. J Korean Soc Plast Reconstr Surg 28: 522, 2001