改良Bilhaut-Cloquet术治疗儿童先天性拇指多指畸形WasselⅣ型的效果分析  

Effect of modified Bilhaut-Cloquet procedure in the treatment of children with congenital thumb polymorphism Wassel Ⅳ

作　　者：马玉龙[1] 杨毅军[1] MA Yu-long;YANG Yi-jun(Department of Orthopaedics,Xi'an Children's Hospital,Xi'an 710032,China)

机构地区：[1]西安市儿童医院骨科

出　　处：《中国医学前沿杂志（电子版）》2019年第6期39-42,共4页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

摘　　要：目的探讨改良Bilhaut-Cloquet术治疗儿童先天性拇指多指畸形WasselⅣ型的临床效果。方法回顾性收集2013年3月至2017年9月于本院住院治疗的43例拇指多指畸形患儿的临床资料,采用传统Bilhaut-Cloquet术治疗的20例患儿纳入传统组,采用改良Bilhaut-Cloquet术治疗的23例患儿纳入改良组。比较两组患儿治疗后Kawabata评分及拇指外观情况。结果两组患儿术后拔除克氏针,截骨处均愈合良好,无感染发生。改良组患儿关节稳定性评分显著高于传统组(P<0.05),指关节活动范围、成角畸形评分均显著低于传统组(均P<0.05),两组患儿疗效无显著差异(P>0.05);改良组患儿指体宽大、指甲畸形发生率均显著低于传统组(均P<0.05),但指体窄小发生率显著高于传统组(P<0.05)。结论改良Bilhaut-Cloquet术治疗儿童拇指多指畸形WasselⅣ型的关节稳定性好,拇指外观较好,值得临床推广应用。Objective To explore the clinical effect of modified Bilhaut-Cloquet procedure in the treatment of children with congenital thumb polymorphism Wassel Ⅳ.Method The clinical data of 43 children with polydactyly thumb who were hospitalized in our hospital from March 2013 to September 2017 were retrospectively collected.20 patients treated with traditional Bilhaut- Cloquet procedure were included in traditional group,and 23 patients treated with modified Bilhaut-Cloquet procedure were included in improved group.Kawabata score and thumb appearance after treatment were compared between the two groups.Result In both groups,the Kirschner wire was removed after operation,and the osteotomy was well healed without infection.The score of joint stability in modified group was significantly higher than that in traditional group (P < 0.05),and the knuckle range and angular deformity scores were significantly lower than that in traditional group (all P < 0.05).There was no significant difference in efficacy between the two groups (P > 0.05).The incidence of finger width and nail malformation in modified group was significantly lower than that in traditional group (all P<0.05),but the incidence of finger narrowness was higher than that in traditional group (P<0.05). Conclusion Modified Bilhaut-Cloquet procedure for the treatment of children's thumb polymorphism Wassel Ⅳ has good joint stability and the appearance of thumb is better.It is an effective treatment and is worthy of clinical application.

关 键 词：多指畸形 Wassel分型 改良Bilhaut-Cloquet术 疗效 

分 类 号：R726.8[医药卫生—儿科]