Bilhaut-Cloquet术治疗复拇畸形的临床效果和常见并发症分析  

Analysis of the treatment outcomes and common complications of Bilhaut-Cloquet surgical procedure for thumb duplication

作　　者：解学关[1] 高伟阳[1] 陈星隆[1] 李志杰[1] 厉智[1] 李晓阳[1] 王安远[1] 郑鑫[1] 张义鹏[1] 

机构地区：[1]温州医学院附属第二医院手外整形外科,温州325027

出　　处：《中华手外科杂志》2011年第1期27-29,共3页Chinese Journal of Hand Surgery

摘　　要：目的评价Bilhaut-Cloquet术治疗先天性复拇指畸形的临床效果，探讨分析其常见并发症的原因。方法2006年至2009年，对15例先天性复拇指畸形患儿分别采用经典和改良Bilhaut-Cloquet术进行治疗，随访观察术后并发症并对疗效进行评价。结果术后15例获得1-20个月的随访，平均6个月。参照Kawabata评分标准：采用经典Bilhaut-Cloquet术者5例，优1例，良3例，差1例；采用改良Bilhaut-Cloquet术者10例，优6例，良3例，差1例。两组中指甲畸形明显者9例，瘢痕挛缩、增生者5例。结论Bilhaut—Cloquet术是治疗复拇指畸形的有效治疗术式，适合于Ⅰ型对等型多拇；Ⅱ型以上的多拇采用改良Bilhaut-Cloquet术更有利于指间关节（Ⅲ）关节活动度的恢复。除了重视关节活动度、稳定性和侧偏畸形的矫正外，指体外观尤其是指甲的精确重建应当得到进一步的重视。Objedive To evaluate the clinical outcomes of Bilhaut-Cloquet surgical procedure for the treatment of thumb duplication, and investigate the causes of common complications. Methods Bilhaut- Cloquet procedure and modified Billaaut-Cloquet procedure were carried out in 15 children with congenital thumb duplication during 2006 to 2009. The patients were follow-up postoperatively to observe any complications and assess the results using Kawabata evaluation criterion. Results The 15 children were follow-up for 1 to 20 months （6 months on average） postoperatively. According to Kawabata evaluation criterion, the Bilhaut-Cloquet procedure achieved excellent results in 1 cases, good in 3 cases, and poor in 1 eases. Modified Bilhaut Cloquet procedure achieved excellent results in 6 cases, good in 3 cases, and poor in 1 case. Nine cases had apparent nail deformity and 5 cases were accompanied by eicatricial contracture and hyperplasia. Conclosion The Bilhaut-Cloquet technique is an effective procedure for the treatment of thumb duplication, especially suitable for type Ⅰ thumb duplication. Modified Bilhaut-Cloquet procedure is more conducive to the recovery of IP range of motion when used in type Ⅱ or more severe thumb duplication. Besides joint range of motion, stability, and correction of lateral deviation, appearance of the thumb especially accurate nall restoration should acquire more attention.

关 键 词：手畸形 先天性 外科手术 随访研究 治疗结果 手术后并发症 

分 类 号：R726.8[医药卫生—儿科]