先天性复拇畸形术后随访分析  

Congenital polydactyly:postoperative short-term follow-up study and outcome analysis

作　　者：华福三 刘同凯 苏玉杰 杨光[1] Hua Fusan;Liu Tongkai;Su Yujie;Yang Guang(Department of Hand Surgery,China-Japan Union Hospital,Changchun 130033,China)

机构地区：[1]吉林大学中日联谊医院手外科,长春130033

出　　处：《中华手外科杂志》2023年第3期227-231,共5页Chinese Journal of Hand Surgery

摘　　要：目的报告先天性复拇畸形手术治疗结果的家长主观评价,及与Chung分型之间的相关性.方法对我院自2019年1月至2021年1月收治的先天性复拇畸形病例33例进行回顾性分析,按照Chung分型,Ⅰ型17例,Ⅱ型4例,Ⅲ型6例,Ⅳ型6例.对患儿家长的主观评价结果进行分析,包括功能和外观VAS评分、术后功能和外观不满意之处、再手术意向、拇指抓握情况、日常生活及社交情况.Chung分型的VAS评分差异比较采用单因素方差分析,其余计量资料采用t检验.结果术后随访时间为15~42个月,平均22.2个月.ChungⅡ型外观评分显著低于Ⅰ、Ⅲ、Ⅳ型的外观评分.Ⅳ型患儿家长再手术意向最低.家长对外观不满意包括拇指偏斜、拇指粗细差异、瘢痕等;对功能不满意包括拇指活动度降低、拇指力量减弱等.其中拇指偏斜、瘢痕、拇指力量减弱对家长外观或功能的评价有显著影响.大部分患儿日常生活和社交评估获得良好的结果.结论复拇畸形术后功能和外观家长短期随访整体满意度较高,指体偏斜是影响术后结果和满意度的主要因素,这些结果均与Chung分型相关.Objective To report the short-term surgical results of polydactyly and to investigate the relationship between postoperative complications of polydactyly and parents'subjective evaluation and Chung classification.Methods A retrospective analysis was made on 33 cases of congenital polydactylyadmitted to our hospital from January 2019 to January 2021.According to Chung's classification,17 cases were typeⅠ,4 cases were typeⅡ,6 cases were typeⅢ,and 6 cases were typeⅣ.The subjective evaluation results of the children's parents were analyzed,including VAS of function and appearance,dissatisfaction with function and appearance after surgery,intention to reoperate,thumb grasping,daily life and social situation.Single factor ANOVA was used to compare the difference of VAS of Chung type,and t-test was used for other measurement data.Results The follow-up period was 15 to 42 months,with an average of 22.2 months.The appearance score of Chung type II was significantly lower than that of typeⅠ,ⅢandⅣ.The parents of type IV children had the lowest intention of reoperation.The parents'dissatisfaction with the appearance included deviation of thumb,difference in thickness of thumb,scar,etc.The dissatisfaction with the function included decreased thumb activity,decreased thumb strength,etc.Among them,deviation of thumb,scar and weakening of thumb strength have a significant impact on the parents'evaluation of appearance or function.The daily life and social assessment of most children achieved good results.Conclusion The overall satisfaction of the parents with the function and appearance after the operation of polydactyly is high.Finger deviation is the main factor affecting the postoperative results and satisfaction.These results are related to Chung classification.

关 键 词：手畸形 先天性 治疗结果 复拇 随访研究 手术后并发症 

分 类 号：R726.8[医药卫生—儿科]