多拇指畸形——"简约而不简单"  

Thumb duplication—"simplicity but not simple"

作　　者：田晓菲[1] 陈山林[2] Tian Xiaofei;Chen Shanlin(Department of Burns Plastic,Children’s Hospital of Chongqing Medical University,Chongqing 400014,China;Department of Hand Surgery,Beijing Ji Shui Tan Hospital,Beijing 100035,China)

机构地区：[1]重庆医科大学附属儿童医院烧伤整形外科,400014 [2]北京积水潭医院手外科,100035

出　　处：《中华整形外科杂志》2020年第7期707-720,共14页Chinese Journal of Plastic Surgery

摘　　要：多拇指畸形是最常见的先天肢体畸形之一,其临床表现多样,术前全面、准确地评估异常结构及严重程度比分型更为重要。手术原则是去掉不需要的结构,把需要的部分重建或组合成一个新的、外观功能良好的拇指。主要治疗方法有副拇指切除+主拇指重建和2个拇指的组合2种。目前,多拇指畸形病因研究虽有进步,但具体发病机制尚不清楚;临床上,缺乏指导治疗并评估预后的理想分类方法,对于复杂的多拇指畸形,治疗结果远未达预期。这类看似"简单"的畸形,至今仍是相关专业医生面临的挑战。该文在大量经典文献及3000余例多拇指的治疗经验基础上,总结了绝大多数多拇指的治疗原则并精炼了手术细节,旨在对相关专业的医生有所裨益。Thumb duplication is one of the most common congenital limb deformities and clinical manifestations vary with malformations in multiple structures.A comprehensive and accurate assessment of abnormal structure and severity is more important than classification before the operation.The principle of surgery is to remove the unwanted structure,keep the useful parts,and reconstruct a good-looking thumb with acceptable functions.There are two major surgical techniques:"excision and reconstruction procedure",and"combined procedure".At present,the etiology research of thumb duplication has made considerable progress but its pathogenesis remains unclear.The classifications are still not good enough to guide the treatment and evaluate the outcome in clinical practice.For complex polythumb deformity,the treatment result are far from expected.And this"simple"deformity remains a challenge for surgeons.This article was written on the basis of many classic literatures and the author’s experiences in the treatment of more than 3000 cases of thumb duplication.The treatment principles of the vast majority of thumb duplication and refinement of the operation details were summarized and we hoped that it could be helpful to doctors with related specialties who often dealed with polythumb deformity.

关 键 词：多拇指 畸形 重建 

分 类 号：R726.8[医药卫生—儿科]