96例小儿先天性复拇畸形显微外科手术治疗疗效的回顾性研究  

A retrospective Study on the Efficacy of Microsurgical Treatment of 96 Cases of Congenital Compound Thumb Deformity in Pediatric Patients

作　　者：黄少帆 黄健曦[1] 魏武贤 何立贤 HUANG Shao-fan;HUANG Jian-xi;WEI Wu-xian(Plastic Burn and Hand Surgery Department,Shantou Central Hospital,Shantou,Guangdong,515000,China)

机构地区：[1]汕头市中心医院整形烧伤和手外科,广东汕头515000

出　　处：《黑龙江医学》2023年第10期1157-1160,共4页Heilongjiang Medical Journal

摘　　要：目的:探讨小儿先天性复拇畸形显微外科手术的临床疗效,为临床上显微外科手术治疗先天性复拇畸形提供指导。方法:回顾性分析2012年1月-2020年8月汕头市中心医院接受显微外科手术治疗的96例先天性复拇畸形患儿的临床资料。收集其Wassel分型,采用Kawabata评分评价保留拇指指间功能;采用复拇畸形美学评分系统(aestheticscoring system,ASS)评价外观美学。结果:WasselⅤ型~Ⅶ型的Kawabata评分高于WasselⅠ型,差异有统计学意义(t=0.445、0.696、1.074,P<0.05);WasselⅦ型先天性复拇畸形患者的优良率显著低于WasselⅠ型,差异有统计学意义(RR=0.571,P<0.05);WasselⅠ型、Ⅱ型、Ⅳ型先天性复拇畸形显微外科术后12个月的ASS高于术后6个月,差异有统计学意义(t=2.996、3.138、1.528,P<0.05);WasselVII型术后12个月的ASS评分高于WasselⅠ型,差异有统计学意义(t=1.879,P<0.05);随Wassel分型的上升,先天性复拇畸形患儿术后患手美学优良率逐渐下降,其中,WasselⅦ型优良率低于WasselⅠ型,差异有统计学意义(RR=0.955,P<0.05)。结论:显微外科手术是治疗小儿先天性复拇畸形的有效方式,治疗效果与Wassel分型有关,Wassel分型越低,功能恢复越好,美观性越好,术后功能与美观程度随术后时间延长而上升。Objective:To discuss the clinical efficacy of microsurgery for pediatric congenital compound thumb deformity,and to provide guidance for clinical microsurgery for congenital compound thumb deformity.Methods:The clinical data of 96 children with congenital compound thumb deformity treated by microsurgery admitted to the hospital from January 2012 to August 2020 were retrospectively analyzed and their Wassel’s staging was collected.The Kawabata score was used to evaluate the retained interphalangeal function of the thumb,and the aesthetic scoring system(ASS)was used to evaluate the aesthetics of the appearance of the compound thumb deformity.Results:Kawabata scores were higher in Wassel V to VII than in Wassel I,with statistically significant differences(t=0.445,0.696,1.074,P<0.05).The excellent rate of patients with Wassel type VII congenital compound thumb deformity was significantly lower than that of Wassel type I,and the difference was statistically significant(RR=0.571,P<0.05).The ASS at 12 months after microsurgery for Wassel I,II,and IV congenital compound thumb deformities was higher than at 6 months after surgery,with a statistically significant difference(t=2.996,3.138,1.528,P<0.05).The ASS score at 12 months after surgery was higher for Wassel type VII than for Wassel type I,with a statistically significant difference(t=1.879,P<0.05).With the rise of Wassel’s staging,the aesthetic excellence rate of the affected hand after surgery in children with congenital compound thumb deformity gradually decreased,with the excellent rate of Wassel type VII being lower than that of Wassel type I,and the difference was statistically significant(RR=0.955,P<0.05).Conclusion:Microsurgery is an effective way to treat congenital compound thumb deformity in pediatric patients.The treatment outcome is related to Wassel’s staging;the lower the Wassel’s staging,the better the functional recovery and the better the aesthetics,and the postoperative functional and aesthetic degree increases with the postoperative period.

关 键 词：小儿 先天性复拇畸形 显微外科手术 功能 美观 

分 类 号：R622[医药卫生—整形外科]