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年龄对拇指多指畸形矫形术后疗效的影响
引用本文:胡建华,曾水平.年龄对拇指多指畸形矫形术后疗效的影响[J].医学信息,2020,0(2):111-112,115.
作者姓名:胡建华  曾水平
作者单位:(江西省吉安市中心人民医院骨科,江西 吉安 343000)
摘    要:目的 比较不同手术年龄的拇指多指畸形矫形术后的疗效,分析年龄对手术效果的影响。方法 收集我院骨科2012年5月1日~2017年5月1日收治并随访获得的120例拇指多指畸形患者,共135个拇指,根据Wassel分型对应的骨化中心出全时间及年龄分为三组。将手术时年龄<骨化中心出全年龄的29例设为A组,手术时年龄≥骨化中心出全年龄且未达成年的82例设为B组,将手术时为成年以后的24例设为C组,比较三组不同Tada评分例数、优良率。结果 三组Ⅰ~Ⅶ型均有Tada评分处于中和差水平,其中A组13指,B组13指,C组8指,三组术后Tada评分例数比较,差异有统计学意义(P<0.05);三组总体优良率为74.81%,B组优良率优于C组及A组,差异有统计学意义(P<0.05)。101指优良(优79指、良22指),34指(中21指、差13指)术后疗效不佳,其中Tada评分为“差”的13指中4指术后3年出现尺偏再次手术纠正偏斜,2指术后对掌功能缺失再次手术;1指外展障碍再次手术,1指术后长期克氏针固定未拔除进行功能锻炼导致关节僵硬。结论 拇指多指畸形进行矫形手术应当在骨化中心出全后至成年之间年龄进行,成年后进行矫形术后疗效相对降低、骨化中心未出全年龄段术后疗效最低。

关 键 词:骨化中心  拇指  多指畸形矫形术

Effect of Age on the Curative Effect of Orthopedic Thumb
HU Jian-hua,ZENG Shui-ping.Effect of Age on the Curative Effect of Orthopedic Thumb[J].Medical Information,2020,0(2):111-112,115.
Authors:HU Jian-hua  ZENG Shui-ping
Affiliation:(Department of Orthopaedics,Central People’s Hospital of Ji’an City,Ji’an 343000,Jiangxi,China)
Abstract:Objective To compare the efficacy of different thumb ages after orthopedic surgery and analyze the effect of age on the outcome of surgery. Methods A total of 135 thumbs were collected from 120 orthopedic patients with thumb deformities admitted and followed up from May 1, 2012 to May 1, 2017 in our department of orthopedics. According to the ossification center corresponding to the Wassel classification, the full time and age points for three groups. The age at operation ossification centers is less than 29 cases out of all ages as A group, age at operation≥ossification centers in the whole and not reached the age of group B 82 is defined as patients after the surgery to 24 adult example set group C, the number of cases, excellent rate Tada comparison of three different scores.Results The Tada scores of all three groups of Ⅰ ~ Ⅶ type were at the level of neutralization. Among them, 13 fingers in group A, 13 fingers in group B, and 8 fingers in group C. The number of Tada scores in the three groups after surgery was statistically significant (P<0.05); the overall excellent rate of the three groups was 74.81%, and the excellent rate of the B group was better than that of the C and A groups, with a significant difference (P<0.05). 101 points were excellent (79 excellent, 22 good) and 34 fingers (middle 21, poor 13). The postoperative curative effect was not good. Among them, 13 of 4 fingers with a Tada score of "poor" showed ulnar deviation after 3 years. Surgery was performed again to correct the deflection, 2 fingers were operated again for lack of palm function after operation; 1 finger was operated again for abduction disorder, and 1 finger was postoperative for a long time with Kirschner wire fixation and functional exercises leading to joint stiffness.Conclusion Orthopedic surgery for thumb multiple finger deformity should be performed between the age of ossification center and adulthood. The effect of orthopedic surgery after adulthood is relatively reduced, and the effect of ossification center is not the lowest after age.
Keywords:Ossification center  Thumb  Orthopedic deformity
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