超声引导下骨骺内闭合截骨治疗儿童先天性拇指尺偏畸形  

Treatment of congenital thumb ulnar deviation in children with closed osteotomy in epiphyseal by ultrasonography

作　　者：孟喜军 于立松 李俊[1] 王敏[2] 沈先涛[1] Meng Xijun;Yu Lisong;Li Jun;Wang Min;Shen Xiantao(Department of Pediatric Orthopedic Surgery,Wuhan Children's Hospital,Tongji Medical College,Huazhong University of Science&Technology,Wuhan 430000,China;Department of Respiratory Medicine,Wuhan Children's Hospital,Tongji Medical College,Huazhong University of Science&Technology,Wuhan 430000,China)

机构地区：[1]华中科技大学同济医学院附属武汉儿童医院骨科,武汉430000 [2]华中科技大学同济医学院附属武汉儿童医院呼吸科,武汉430000

出　　处：《临床小儿外科杂志》2024年第2期158-161,共4页Journal of Clinical Pediatric Surgery

基　　金：湖北省自然科学基金资助项目(2013CKB026)

摘　　要：目的探讨超声在儿童先天性拇指尺偏畸形中的应用。方法回顾性分析2018年7月至2021年2月华中科技大学同济医学院附属武汉儿童医院骨科收治的8例(10拇)采用超声引导下骨骺内闭合截骨治疗先天性拇指尺偏畸形的患儿资料,男4例、女4例,单侧3例、双侧5例。测量患儿术前、术后的尺偏角、指间关节主动屈曲角,采用Tada评分标准进行疗效评估(包括指间关节运动范围、稳定性、力线)。结果8例(10拇)均获得随访,随访时长(21.75±11.83)个月。术前拇指尺偏角(40.12±13.44)°,指间关节主动屈曲角(38.90±5.34)°;术后拇指尺偏角(7.65±2.56)°,指间关节主动屈曲角(36.20±3.36)°;对比10拇的术前及术后尺偏角、指间关节主动屈曲角,差异均有统计学意义(P<0.05)。根据Tada评分标准评估疗效:良好8拇、中等2拇。结论超声引导下行儿童先天性拇指尺偏畸形截骨治疗,可以提供相对准确的定位,是一种有效的方法。Objective To explore the application of ultrasonography for congenital thumb ulnar deviation in children.Methods From July 2018 to February 2021,the relevant clinical datas were retrospectively reviewed for 8 children(10 thumbs)undergoing ultrasound-guided closed osteotomy in epiphyseal.There were 4 boys and 4 girls.Involvement was unilateral(n=3)and bilateral(n=5).Ulnar deviated angle and actively flexion angle of interphalangeal joint and Tada scoring standard were measured for evaluating thumb functions(range of motion,joint stability and alignment of interphalangeal joint).Results The results showed that 8 cases with 10 thumbs were followed up for a period of(21.75±11.83)(8-57)months.Average preoperative values of ulnar deviated angle of thumb and mean actively flexion angle of interphalangeal joint were(40.12±13.44)°and(38.90±5.34)°.At the final follow-up,mean values of ulnar deviated angle of thumb and actively flexion angle of interphalangeal joint were(7.65±2.56)°and(36.20±3.36)°.Comparing the preoperative ulnar deviated angle and actively flexion angle of interphalangeal joint in 10 children with thumb,there were significant statistical differences(P<0.05).According to the Tada scoring criteria(range of motion,joint stability and alignment of interphalangeal joint),the outcomes were excellent(8 thumbs)and decent(2 thumbs).Conclusions With an accurate localization,ultrasonography is an effective method for osteotomy with congenital thumb ulnar deviation in children.

关 键 词：超声 骨骺畸形 截骨 外科手术 儿童 

分 类 号：R726.8[医药卫生—儿科]