探讨3岁以下小儿单纯手指掌侧瘢痕增生或（伴）挛缩畸形的修复时机与方式。

2012年3月至2024年12月，空军军医大学第一附属医院烧伤与皮肤外科及安康市中心医院烧伤整形与创面修复科收治3岁以下单纯手指掌侧瘢痕增生或（伴）挛缩畸形患儿52例，其中男28例，女24例，年龄（1.6±0.7）岁，共151个手指受累。根据瘢痕范围及手指功能等指标将患指分为Ⅰ型、Ⅱ型和Ⅲ型。Ⅰ型采取保守治疗并随访观察，待瘢痕软化后根据其对手指功能的影响程度决定是否行手术治疗；Ⅱ型以保守治疗为主，待瘢痕软化形成蹼状瘢痕后行Z型皮瓣修复，避免植皮；Ⅲ型采取手术治疗，切除增生性瘢痕并对挛缩进行彻底松解，利用指侧皮肤形成局部皮瓣转移修复指蹼及第一指横纹，继发创面行自体全厚皮移植，术中可用克氏针于软组织中固定手指于伸直位，不贯穿指骨。随访观察手指外观及功能改善情况。

Ⅰ型45个手指，随访1~5年，均未行手术治疗，手指功能正常；Ⅱ型36个手指，经保守治疗并随访1~6年，其中8个手指在瘢痕增生期行局部皮瓣转移修复，28个手指在形成蹼状瘢痕后行局部皮瓣转移修复，均未行自体皮移植；Ⅲ型70个手指，按预期方案行手术治疗，术后皮瓣及植皮均成活，随访1~7年，手指功能恢复良好，未再次行手术治疗。

对小儿单纯手指掌侧瘢痕进行临床分型，选择适当的治疗时机及手术方式，可以在保障患儿手指功能及发育的同时，减少手术次数，获得更好的治疗效果。

To investigate the repair timing and operation method for palmar scar of finger in children under 3 years of age.

From March 2012 to December 2024， 52 pediatric patients under 3 years of age with isolated palmar finger scar hyperplasia with or without contracture deformity were admitted to the Department of Burns and Cutaneous Surgery of the First Affiliated Hospital of Air Force Medical University， and the Department of Burns， Plastic Surgery and Wound Repair of Ankang Central Hospital， including 28 males and 24 females， aged （1.6±0.7） years with a total of 151 fingers affected. Based on the extent of scarring and finger function， the fingers were classified into typeⅠ， type Ⅱ， and type Ⅲ. Type Ⅰ fingers were managed conservatively with regular follow-up， and surgical intervention was considered after scar softening depending on the degree of impact on finger function. Type Ⅱ fingers were primarily managed conservatively， with Z-plasty flap repair performed after scar softening and web-like scar formation， thereby avoiding skin grafting. Type Ⅲ fingers underwent surgical treatment， including resection of hypertrophic scars and thorough release of contractures. Local flaps from the lateral fingers were used to repair the finger web and the first transverse crease， while secondary wounds were covered with full-thickness autologous skin grafts. During the operation， Kirschner wires were used to immobilize the fingers in an extended position within the soft tissue without penetrating the phalanges. Observed the improvement of finger appearance and function during follow-up.

All 45 type Ⅰ fingers were managed non-operatively and followed up for 1–5 years with normal finger function. Among the 36 type Ⅱ fingers， 8 fingers received local flap transfer repair during the scar proliferation stage， and 28 fingers underwent local flap transfer repair after web-like scar formation， with a follow-up of 1–6 years. None required autologous skin grafting. All 70 type Ⅲfingers underwent surgical treatment according to the planned protocol. Postoperatively， both flaps and skin grafts survived completely， with satisfactory restoration of finger function， no secondary surgical intervention was required during a follow-up of 1–7 years.

Clinical classification of simple palmar finger scars in children， along with appropriate selection of therapeutic timing and surgical methods， can protect finger function and growth， reduce the number of operations， and achieve better therapeutic outcomes.