先天性拇指多指畸形的临床与影像学特征  

Clinical and radiographic features of congenital thumb polydactyly

作　　者：吴剑平 李晨阳 廖世杰[2] 石伟哲 洪恺 龚明 黎艺强 李敬春 刘远忠 徐宏文 Wu Jianping;Li Chenyang;Liao Shijie;Shi Weizhe;Hong Kai;Gong Ming;Li Yiqiang;Li Jingchun;Liu Yuanzhong;Xu Hongwen(Department of Pediatric Orthopedics,Guangzhou Women and Children's Medical Center,Guangzhou Medical University,Guangdong Provincial Clinical Research Center for Child Health,Guangzhou 510623,China;Department of Orthopedics,the First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China)

机构地区：[1]广州医科大学附属妇女儿童医疗中心儿童骨科,广州510623 [2]广西医科大学第一附属医院创伤骨科手外科,南宁530021

出　　处：《中华手外科杂志》2025年第1期28-32,共5页Chinese Journal of Hand Surgery

基　　金：广州市卫生健康科技项目(20231A011039)。

摘　　要：目的:研究分析先天性拇指多指畸形的性别、侧别、分型、合并畸形等的临床与影像学特征。方法:收集自2015年8月至2024年3月在我院诊治的先天性拇指多指畸形患者资料,利用SPSS 20.0等软件进行统计并分析拇指多指畸形的临床与影像学特征。结果:共有先天性拇指多指畸形3279例,男2037例(62.1%),女1242例(37.9%),男女比为1.6∶1;右侧1856例(56.6%),左侧1122例(34.2%),双侧301例(9.2%),右左比为1.7∶1,单双比为9.9∶1。合并畸形391例(11.9%),其中小指中节指骨畸形最常见,占72.6%。无法按Chung分型方法归类的特殊拇指多指畸形2指(0.1%),无法按Wassel分型方法归类的特殊拇指多指畸形625指(17.4%)。结论:先天拇指多指畸形男孩多见,单侧高发,散发病例多见,合并小指中节指骨发育畸形最为常见。现有的Wassel分型不够全面,手术治疗指导意义不大,Chung分型不利于临床交流,Wu分型有助于临床交流与手术策略选择,但需进一步的大样本临床研究证实。Objective:To study and analyze the clinical and radiographic features of congenital thumb polydactyly,such as sex,side,classification and associated anomaly.Methods:Data of patients with congenital thumb polydactyly treated in our hospital from August 2015 to March 2024 were collected.SPSS 20.0 and other software were used to make statistical analysis and analyze the clinical and imaging features of thumb polydactyly.Results:There were 3279 cases of congenital thumb polydactyly,including 2037 males(62.1%)and 1242 females(37.9%),with a male to female ratio of 1.6∶1.There were 1856 cases(56.6%)on the right side,1122 cases(34.2%)on the left side,and 301 cases(9.2%)on both sides.The right-left ratio was 1.7∶1,and the unilateral-bilateral ratio was 9.9∶1.There were 391 cases(11.9%)of combined deformities,among which the deformity of the middle phalanx of the little finger was the most common,accounting for 72.6%.Two fingers(0.1%)of special thumb polydactyly cannot be classified according to the Chung classification method,and 625 fingers(17.4%)of special thumb polydactyly cannot be classified according to the Wassel classification method.Conclusion:Congenital polydactyly of the thumb is more common in boys,with a high incidence on one side and sporadic cases.It is most common to have developmental abnormalities of the middle phalanx of the little finger.The existing Wassel classification is not comprehensive enough,and the guidance for surgical treatment is not significant.Chung classification is not conducive to clinical communication,while Wu classification is helpful for clinical communication and surgical strategy selection,but further large-scale clinical studies are needed to confirm it.

关 键 词：拇指 多指(趾)畸形 临床特征 影像学特征 分型 

分 类 号：R681.7[医药卫生—骨科学] R726.8[医药卫生—外科学]