截骨矫形可吸收棒填充治疗先天性第四、五掌骨融合畸形  

Treatment of congenital fourth and fifth metacarpal synostosis with longitudinal osteotomy and absorbable rod interposition

作　　者：陈斌[1] 李红卫[1] 李大为[1] 王军[1] Chen Bin;Li Hongwei;Li Dawei;Wang Jun(Department of Hand Surgery,Zhengzhou Orthopedic Hospital,Henan 450052,China)

机构地区：[1]郑州市骨科医院手外科,河南450052

出　　处：《中华手外科杂志》2021年第5期347-350,共4页Chinese Journal of Hand Surgery

摘　　要：目的初步总结并探讨应用截骨矫形可吸收棒填充治疗先天性第四、五掌骨融合畸形的临床疗效。方法回顾性分析自2014年8月至2019年12月在我科接受治疗的先天性第四、五掌骨融合小指外展畸形患儿6例8侧,手术方法采用第四、五掌骨纵行截骨,可吸收棒填充截骨间隙,克氏针及石膏辅助固定,对术前、术后外观及影像学指标等进行评价,结果本组8侧术后伤口均丨期愈合。术后4周患手基本恢复正常外观,复查X线片见第四、五掌骨间夹角在正常范围8°~23°,平均(14±4)°;小指力线恢复良好,环小指力线轴夹角为3°~10°,平均(7±2)°。术后1个月、3个月、1年进行随访,患手外观无明显再发畸形出现。结论应用纵行截骨、可吸收棒填充治疗先天性第四、五掌骨融合小指外展畸形临床效果良好,值得进一步推广探讨。Objective To summarize and explore the clinical efficacy of longitudinal osteotomy and absorbable rod interposition in the treatment of congenital fourth and fifth metacarpal synostosis.Methods From August 2014 to December 2019,6 cases(8 sides)of congenital fourth and fifth metacarpal synostosis and little finger abduction deformity were treated in our department.The fourth and fifth metacarpal longitudinal osteotomy,absorbable rod filling osteotomy space,Kirschner wire and plaster assisted fixation were used.The preoperative and postoperative appearance and imaging indexes were evaluated.Results All the wounds achieved primary healing.Four weeks after operation,the appearance of the affected hand returned to normal.X-ray films showed that the angle between the fourth and fifth metacarpals was in the normal range of 8°to 23°with an average of(14±4)°;the force line of the little finger recovered well with an average of(7±2)°,and the angle between the force line axis of the ring little finger was 30 to 10o.After 1 month,3 months and 1 year of follow-up,there was no obvious recurrence of hand deformity.Conclusion The application of longitudinal osteotomy and absorbable rod interposition in the treatment of congenital fourth and fifth metacarpal synostosis with little finger abduction deformity has good clinical efficacy,which is worthy of further promotion.

关 键 词：手畸形 先天性 治疗结果 骨融合 可吸收棒 

分 类 号：R726.8[医药卫生—儿科]