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Hisham Abdel Ghani Ahmed El-Naggar Mohamad Hegazy Atef Hanna Yehia Tarraf Samia Temtamy 《Journal of children's orthopaedics》2007,1(5):313-322
Purpose Congenital clasped thumb is a deformity that is associated with heterogeneous congenital anomalies and it has been addressed
in many congenital syndromes. The aim of this study was to diagnose and evaluate cases of clasped thumb as regards the associated
congenital anomalies and syndromes, and evaluation of the results of treatment of such cases.
Methods A prospective study on 40 patients with 73 clasped thumbs was done. All the patients’ data regarding their personal, family,
pregnancy and developmental histories were recorded. All the patients were exposed to thorough clinical and radiological examination
and genetic assessment. The cases were classified using the Tsuyuguchi et al. (J Hand Surg [Am] 10:613–618, 1985) classification into three types. Conservative treatment was adopted in ten hands, and surgical treatment was performed for
28 hands in 17 patients, with an average follow-up of 26 months.
Results Positive consanguinity was recorded in 57.5% of cases. Associated anomalies were recorded in 77.5% of cases. Type I was the
most common one, followed by type III and then type II. Conservative treatment is effective in type I cases when presented
early, and all patients were satisfied with the results of surgical treatment.
Conclusions We reported associated anomalies which are to our knowledge have not mentioned before in the literature which include; congenital
blindness, radial deviation of the index finger and ventricular septal defect. We found that 68% of the patients had associated
syndromes, and this has not been mentioned before. In this study, we found that there were no difference between type II and
type III clasped thumb as regards the pathological findings, severity, the operative procedures, the treatment protocol and
the operative results. Properly planned treatment gives satisfactory results. 相似文献
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目的:总结Ⅰ期在第2足趾游离移植再造拇(手)指中行趾甲延长的临床应用经验.方法:采用趾甲延长方法对9例(男7,女2例)第2足趾移植再造拇(手)指的患者进行了趾甲延长术,其中拇指8例,食指1例.年龄18~46岁,平均25岁.在再造指距甲根皮缘5 mm处,去除1块矩形皮肤,勿损伤皮下血管网.其高度2 mm,宽度与趾甲相等,将U形皮瓣向近端柔和推剥并缝合.结果:1例术后供区发生表浅感染,经换敷料逐渐愈合.再造的拇(手)指全部成活,可延长趾甲2~3 mm,改善了再造拇(手)指的外形,无指甲生长畸形发生.随访7个月~2年(平均13个月),趾甲外形较好.结论:在第2足趾游离移植再造拇(手)指中应用Ⅰ期趾甲延长术,使趾甲从短小向纵向延长,缩小手指甲与足趾甲之间差异,能改善再造拇(手)指甲外形,且不影响再造指的活动功能,是一种简单有效的手术方法. 相似文献
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游离足趾移植急诊拇手指再造106例 总被引:1,自引:0,他引:1
目的总结游离足趾移植急诊拇手指再造的临床经验,进一步探讨游离足趾移植急诊拇手指再造的可行性.方法 1997年1月~2005年2月收治外伤性拇手指缺损患者106例,清创后,采用(足母)趾移植急诊再造拇指8例,第二足趾移植再造拇指69例、再造中指7例、再造食指4例、再造环指3例、再造手1例,双侧第二足趾移植同时再造拇食指3例、再造食中指7例、再造中环指3例、再造手1例.结果再造拇手指106例119指成活118指,无一例感染,经3~66个月随访,所有再造拇手指血运丰富,感觉恢复良好,对指和对掌灵活.结论对于外伤性拇手指缺损,经过彻底清创,科学设计,采用游离足趾移植急诊再造,可以获得满意的再造效果. 相似文献
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总结1966年2月至1994年2月的足趾移植术400例,以正确评佑足趾移植在拇、手指再造中的作用。再造方法:单纯第2趾移植(带或不带跖趾关节)299例,第2、3趾联合移植28例,第2趾带第3趾近节趾骨1例,第2趾伴各种皮瓣移位或移植66例,甲瓣伴第2趾第2趾移植6例。移植成活386例,失败14例,成活率为96.5%。240例获得2年以上的功能随访,再造指的运动与感觉功能优良率达90%以上·足的功能满足率达86%-91%。对各种再造方法的手术指征,血循危象的防治,提高功能效果的关键及趾移植后足的功能影响等进行了详细分析。总体评价为:(1)足趾移植是再造拇、手指比较理想的方法。(2)单纯切除第2趾不论跖骨头是否保留均不造成足的功能及生物力学的明显改变。(3)随着足部切除组织的增加,术后足的外形、功能及生物力学的变化也加大。 相似文献
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介绍几种残指延长拇指再造的方法 总被引:1,自引:0,他引:1
本文报告带血管神经蒂组织瓣移位及手残指缓慢延长术治疗64例拇指缺损,拇指平均延长2.6cm,平均随访时间3年6个月,再造拇指外形及功能均较满意。本法简单、安全、有效。拇指掌指关节以远缺如,残端指骨长1cm以上者行指骨延长术,不足1cm者可行第1掌骨延长术、二期行虎口加深术。掌指关节平面缺如采用第1掌骨延长术或带血管蒂皮瓣移位再造拇指。也可用带桡骨片的前臂桡侧皮瓣一期再造拇指。第1掌骨近侧平面缺如, 相似文献
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Aspergillus osteomyelitis is a rare condition and is a recognized infection of the immunosuppressed. The pediatric cases that were documented suggest that in children, chronic granulomatous disease is the major underlying disease [Tack et al.1982 73(2):295–300, Baez-Escudero et al. 2000 Case report—primary sternal Aspergillus osteomyelitis. Infect Med 17(7):505–516]. We report an interesting case of Aspergillus osteomyelitis of the thumb in a 5-year-old boy with aplastic anemia. The infection progressed despite a combination of antifungal therapy with Voriconazole and surgical debridement. The thumb was amputated and the child recovered. This case highlights the difficulty in diagnosing Aspergillus osteomyelitis and also the failure of conventional management in this child, which resulted in the amputation of the thumb as a life-saving measure. We believe this to be the first case report of Aspergillus osteomyelitis in the thumb. 相似文献