拇指多指切除截骨矫形克氏针内固定术治疗先天性拇指多指畸形患儿的效果  

Efficacy of thumb polydactyly resection,osteotomy,and kirschner wire internal fixation in the treatment of congenital thumb polydactyly in children

作　　者：郭占豪 王子木 王军建 朱豪伟 GUO Zhan-hao;WANG Zi-mu;WANG Jun-jian;ZHU Hao-wei(Department of Orthopedics,Henan Children's Hospital(Zhengzhou Children's Hospital/Children's Hospital Affiliated to Zhengzhou University),Zhengzhou 450018,Henan,CHINA)

机构地区：[1]河南省儿童医院(郑州儿童医院/郑州大学附属儿童医院)骨科,河南郑州450018

出　　处：《海南医学》2025年第7期981-985,共5页Hainan Medical Journal

基　　金：河南省医学科技攻关计划联合共建项目(编号:LHGJ20190951)。

摘　　要：目的研究拇指多指切除截骨矫形克氏针内固定术在先天性拇指多指畸形患儿治疗中的应用效果。方法选取2022年4月至2023年4月河南省儿童医院收治的100例先天性拇指多指畸形患儿作为研究对象,按随机数表法分为对照组和观察组,每组50例。对照组患儿采用常规治疗方案,观察组患儿采用多指切除截骨矫形克氏针内固定术治疗方案。以Kawabata评分作为参考,比较两组患儿术后6个月指关节活动范围、成角畸形、指关节稳定性情况,术后6个月内定期对患儿进行回访,记录术后患儿在社交态度上的改善情况,同时对患儿家属进行回访,比较两组患儿家属对手术治疗的满意度。结果观察组患儿术后的关节活动范围、指关节稳定性及成角畸形评分分别为(1.75±0.22)分、(1.58±0.37)分、(0.88±0.23)分,明显高于对照组的(1.32±0.38)分、(1.32±0.37)分、(0.62±0.27)分,差异均有统计学意义(P<0.05);观察组患儿的手术优良率为96.00%,明显高于对照组的86.00%,差异有统计学意义(P<0.05);术后,两组患儿的社交积极率均升高,且观察组患儿术后社交积极率为58.00%,明显高于对照组38.00%,差异均有统计学意义(P<0.05);观察组患儿家属对手术的满意度为90.00%,明显高于对照组的78.00%,差异有统计学意义(P<0.05)。结论拇指多指切除截骨矫形克氏针内固定术治疗先天性拇指多指畸形的临床效果显著,具有较高的临床应用价值。Objective To investigate the efficacy of thumb polydactyly resection,osteotomy,and Kirschner wire internal fixation in the treatment of congenital thumb polydactyly in children.Methods A total of 100 children with congenital thumb polydactyly admitted to Henan Children's Hospital from April 2022 to April 2023 were selected as the study subjects.They were randomly divided into a control group and an observation group,with 50 cases in each group.Patients in the control group received conventional treatment,while those in the observation group underwent polydactyly resection,osteotomy,and Kirschner wire internal fixation.The Kawabata score was used as a reference to compare the range of motion,angular deformity,and joint stability of the fingers between the two groups at 6 months postoperatively.Regular follow-ups were conducted within 6 months after surgery to record improvements in the children's social attitudes.Additionally,the families of the children were surveyed to compare their satisfaction with the surgical treatment.Results The postoperative scores for joint range of motion,joint stability,and angular deformity in the observation group were(1.75±0.22)points,(1.58±0.37)points,and(0.88±0.23)points,respectively,significantly higher than(1.32±0.38)points,(1.32±0.37)points,and(0.62±0.27)points in the control group(P<0.05).The excellent and good rate of surgery in the observation group was 96.00%,significantly higher than 86.00%in the control group(P<0.05).Postoperatively,the positive social engagement rate increased in both groups,with the observation group reaching 58.00%,significantly higher than 38.00%in the control group(P<0.05).The satisfaction rate among the families of the observation group was 90.00%,significantly higher than 78.00%in the control group(P<0.05).Conclusion Thumb polydactyly resection,osteotomy,and Kirschner wire internal fixation demonstrate significant clinical efficacy in the treatment of congenital thumb polydactyly,offering high clinical application value.

关 键 词：儿童 先天拇指多指 多指切除 克氏针内固定术 截骨矫形 手指功能 

分 类 号：R729[医药卫生—儿科]