软组织矫形在先天性复拇指畸形矫治中的价值  

The efficacy of soft tissue plasty in the treatment of congenital duplication of the thumb

作　　者：刘有余[1] 何明武[1] 姚忠军[1] 詹祖峰[1] 李亢[1] 刘堂鑫[1] 

机构地区：[1]湖北医药学院附属太和医院手外科,湖北442000

出　　处：《中华手外科杂志》2013年第2期89-91,共3页Chinese Journal of Hand Surgery

摘　　要：目的报告软组织矫形在先天性复拇指畸形（Wassel分型Ⅱ、Ⅲ、Ⅳ型）矫治中的疗效。方法对78例83指按照Wassel分型属于Ⅱ、Ⅲ、Ⅳ型先天性复拇指畸形的患儿，在处理骨骼的同时对指伸、屈肌腱行松解和力线重建、侧副韧带重建、拇短展肌止点重建及利用废弃指轴型皮肤复合组织瓣修复残指外观等处理。术后随访观察拇指外形及功能恢复情况。结果术后72例76指获得随访，6例7指失访，随访时间为6个月至5年，其中4例5指出现继发畸形，经再次手术矫形后，外观及功能恢复良好，其余71指术后拇指外观及功能均得到明显改善，优良率为93．4％。结论在复拇指畸形的矫治中软组织综合矫治亦起着至关重要的作用。Objective To report the clinical results of applying soft tissue plasty in the treatment of Wassel type II , III, and IV congenital duplication of the thumb. Methods A retrospective study was conducted in 83 fingers of 78 children that were classified as Wassel type II, type III and type IV congenital thumb duplications. In addition to bony corrections, release and re-alignment of the flexor and extensor tendons, reconstruction of the collateral ligaments, and reattachment of the abductor pollieis brevis insertion were done. The axial skin composite tissue flap from the removed duplicate thumb was used to restore the appearance of the remaining thumb. Postoperatively the shape and functional recovery of the thumb was observed. Results Seventy-six thumbs of 72 cases had sufficient follow-up ranging from 6 months to 5 years. Seven thumbs of 6 cases were lost to follow-up. Among the ones with sufficient follow-up, 5 thumbs of 4 cases showed secondary deformities. Another revision procedure restored the appearance and function of these thumbs. The appearance and function of the remaining 71 thumbs were significantly improved. The overall excellent rate was 93.4%. Conclusion Soft tissue plasty also plays a vital role in the treatment of congenital thumb duplication.

关 键 词：手畸形 先天性 矫形外科手术 分型 

分 类 号：R726[医药卫生—儿科]