改良Bilhaut-Cloquet法治疗对称型末节先天性复拇指畸形  

The Modified Bilhaut-Cloquet Method in the Treatment of Congenital Symmetric Distal Thumb Deformities

作　　者：许清华[1] 孙广峰[1] 金文虎[1] 聂开瑜[1] 邓呈亮[1] 李书俊[1] 魏在荣[1] 王达利[1] XU Qing-hua SUN Guang-feng JIN Wen-hu NIE Kai-yu DENG Cheng-liang LI Shu-jun WEI Zai-rong WANG Da-li(Department of Plastic and Hand Surgery, Affilicated Hospital of Zunyi Medical College,Zunyi 563000,Guizhou,Chin)

机构地区：[1]遵义医学院附属医院整形手外科,贵州遵义563009

出　　处：《中国美容医学》2017年第2期20-23,共4页Chinese Journal of Aesthetic Medicine

基　　金：国家临床重点专科基金;国卫办医函[2013]544

摘　　要：目的:探讨改良Bilhaut-Cloquet法治疗对称型末节先天性复拇指畸形临床疗效。方法:自2010年1月至2014年12月收治对称型末节先天性复拇指畸形28例28指,其中男10例,女18例;年龄最小2岁,最大22岁,平均5.5岁;复拇指的2指指甲宽度均小于对侧正常拇指的85%;其中轴线正常型12例、轴线偏移型16例。采用Bilhaut-Cloquet术+指间关节关节囊侧副韧带修复16例,采用Bilhaut-Cloquet术+指间关节关节囊侧副韧带修复+近节指骨颈部截骨治疗12例。手术效果参照Kawabata评分方法结合拇指外观、指甲是否有畸形,患者或家属对手指外观功能的满意度制作评价表进行测评。结果:随访6~24个月,拇指指间关节26例轴线恢复正常,2例指间关节轴线偏离;26例指间关节稳定,2例指间关节不稳定;25例末节能够伸直,3例伸直轻度受限;28例拇指対掌功能均良好,指甲大小接近正常;2例指甲继发突脊畸形,26例指甲外观满意,切口瘢痕增生不明显。优24指,良2指,可2指,优良率92.9%。结论:改良Bilhaut-Cloquet法治疗对称型末节先天性复拇指畸形,操作难度不大,可以获得较好的疗效,值得推广应用。Objective To explore the clinical curative effect of the modified Bilhaut-Cloquet in the treatment of congenital symmetric distal thumb deformities. Methods The retrospective analysis of 2010 January 2014 December symmetric distal congenital thumb duplication deformity were 28 cases,which 10 cases were males and 18 females; the youngest was 2 years old, the oldest was 22 years old,with an average of 5.5 years old; 2 finger＇s nail width of thumb duplication were less than 85% of the contralateral normal thumb; one axis normal type in 12 cases, the axis offset type in 16 cases.The Bilhaut-Cloquet operation＋interphalangeal joint capsular lateral collateral ligament repairation in 16 cases,12 cases of proximal phalanx neck osteotomy with Bilhaut-Cloquet operation＋interphalangeal joint capsular lateral collateral ligament repairation. The surgical effect was evaluated by using Kawabata score method combined with the appearance of the thumb, whether there was a deformity nail,and the appearance of the patients or family members. Results All patients were followed up for 6-24 months follow-up, the thumb interphalangeal joint axis in 26 cases returned to normality,2 cases of interphalangeal joint axis turned to deviation, 26 cases＇ interphalangeal joint turned to stability,2 cases＇ s interphalangeal joint turned to instability, 25 cases of thumb distal turned to be able to straighten,3 cases had little limitation to straighten,28 cases＇ palm had good function, nail returned to normality.nail turned to ridges malformation in 2 cases,26 cases＇ nail appearance satisfied, hypertrophic scar is not obvious. Excellent 24 fingers,good 2 fingers fair 2 fingers, excellent rate of 92.9%. Conclusion The modified Bilhaut-Cloquet method in the treatment of symmetric distal congenital thumb deformities is not difficult to operate,can obtain better curative effect,it is worthy of popularization and application.

关 键 词：复拇指畸形 多指畸形 改良Bilhaut-Cloquet术 侧副韧带修复 截骨 

分 类 号：R622[医药卫生—整形外科]