Ilizarov牵张成形技术矫正中重度虎口挛缩  

Ilizarov technique for correction of moderate-severe thumb web contracture

作　　者：浦绍全 朱跃良[1] 吕乾 赵永辉 赵泽雨 夏燊 齐欣[1] 徐永清[1] PU Shao-quan;ZHU Yue-liang;LV Qian;ZHAO Yong-hui;ZHAO Ze-yu;XIA Sheng;QI Xin;XU Yong-qing(Department of Orthopedics,The 902 Hospital,Logistic and Support Force of PLA,Kunming 650032,China;Department of Orthopedics,the First People's Hospital of Yunnan Province,the Affiliated Hospital of Kunming University of Science and Technology,Kunming 650032,China)

机构地区：[1]中国人民解放军联勤保障部队第920医院骨科,云南昆明650032 [2]云南省第一人民医院骨科,昆明理工大学附属医院,云南昆明650032

出　　处：《中国矫形外科杂志》2021年第19期1789-1791,共3页Orthopedic Journal of China

基　　金：云南省创伤骨科临床医学中心项目(编号:ZX20191001)。

摘　　要：[目的]介绍Ilizarov牵张成形技术矫正中重度虎口挛缩的手术技术和初步临床效果。[方法]2016年2月-2019年12月,采用Ilizarov牵张成形技术矫正外伤后重度虎口挛缩7例。其中男4例,女3例;年龄22〜50岁,平均(34.43±9.54)岁。所有患者均在第1、第2掌骨头及基底上斜45°避开肌腱各穿入2枚2.5 mm的螺纹针,安装简易外固定撑开器,术后逐渐撑开虎口,满意后继续外固定支架维持虎口撑开状态3周,随后取出外固定器,夜间应用虎口开大支具维持至6周,防止虎口挛缩。[结果]所有患者术后均获得随访,随访时间8〜20个月,平均(14.71±4.20)个月。7例患者经治疗后均达到临床撑开,治疗过程中患者疼痛不明显,依从性好。虎口均得到良好的撑开,无皮肤牵拉并发症发生。[结论]Ilizarov牵张成形术操作简单,是治疗外伤后虎口狭窄的有效方法。[Objective]To introduce the surgical technique and preliminary clinical results of the Ilizarov technique of distraction histogenesis for correction of moderate-severe thumb web contracture.[Methods]From February 2016 to December 2019,7 patients,includ-ing 4 males and 3 females,aged from 22〜50 years,with an average of(34.43±9.54)years,underwent the abovesaid surgical treatment in our hospital for moderate-severe thumb web contracture secondary to trauma.As two 2.5 mm threaded pins were inserted into the metacarpal head and base respectively on the first and second metacarpals in 450 oblique angle with caution to avoid tendons involved,a proper exter-nal frame pre-installed was attached with the pins by the clamps.After operation,the thumb web was stretched gradually by the Ilizarov frame.As satisfactory correction achieved,the frame was remained without further distraction of the thumb web for 3 weeks.Subsequently,the external fixation was removed and a thumb web open brace was used to maintain it at night for another 6 weeks to prevent the thumb web contracture again.[Results]All patients were followed up for 8〜20 months with an average of(14.71±4.20)months after surgery.All the 7 patients got the first web opening satisfactorily after the treatment,with good compliance,while without obvious pain and skin traction complications.[Conclusion]The Ilizarov distraction technique is a simple and effective treatment for moderate-severe thumb web contracture secondary to trauma.

关 键 词：中重度虎口挛缩 ILIZAROV技术 牵伸组织生长 

分 类 号：R687[医药卫生—骨科学]