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患者,女性,9岁,因发现双手拇指末节指骨尺偏畸形9年入院。患者出生时即发现双手拇指末节指骨尺偏,随年龄增长,畸形无明显加重,拇示指做精细活动稍有影响,为追求美观和改善拇指功能入院治疗。查体:双手拇指末节指骨尺偏畸形达60°,指间关节屈伸正常。X线片示:双手拇指指骨间见一三角形骨块(delta骨)(图1)。1治疗指根麻醉,左手取拇指指间关节桡侧纵切口,长约2cm,切开指间关节囊,见指骨间一独立的delta骨,其远端与末节指骨部分关节面接触,近端与近节指骨形成关节且可屈伸活动。将delta骨取出(图2),紧缩缝合桡侧关节囊及皮肤。同法处理右手,不… 相似文献
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1997年及 1998年 ,我院曾收治 1家族姐弟俩“角形拇”畸形患者 ,追踪随访发现该家系有 4代 10例相似的手畸形 ,报道如下。一、资料与方法1 一般资料 :先证者 (Ⅳ 3 ) ,男 ,11岁。出生后发现双拇远端尺偏畸形 ,偏斜度未随年龄增大而改变。指间关节屈曲较健侧差 ,伸直时拇背皮肤有 2条成角皱折线 ,拇指指腹对掌正常(图 1)。患者因羞于示人 ,习惯将双拇握藏于掌心。X线片 :双拇末节向尺侧偏斜 ,两指骨间有外宽内窄楔状中节指骨存在 ;远节指骨关节面与远节纵轴垂直。先证者之姐 (Ⅳ 2 ) ,13岁 ,同样有双拇畸形 ,右拇伴有多指畸形。年幼时曾将多… 相似文献
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先天性三节指骨拇畸形 总被引:1,自引:0,他引:1
先天性三节指骨拇畸形安捷王玉琨王承武3节指骨拇是罕见的先天性畸形。拇指指间关节内有一多余三角形骨块,又称为“delta指骨”。常表现拇指末节向示指偏斜,影响手指精细活动和外观。国内未见报道。我院小儿骨科1986~1994年共收治6例。临床资料6例患者... 相似文献
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Congenital clasped thumb in palm corresponds to a spectrum of anomalies leading to a loss of thumb extension and abduction. Intrinsic muscles and skin shortening are not infrequent. Conservative orthopedic treatment should be undergone as soon as possible. When this treatment fails, or when patients are seen late, surgical correction has to be customized according to the involved structures. The trigger thumb is 10 times more frequent than the trigger finger. It is bilateral in 30% of the cases. The term "congenital" remains unclear as several investigations on newborns have not evidenced trigger thumb. In children, it is very rare to find a real trigger and presentation consists in a fixed flexion deformity of the interphalangeal joint. Diagnosis is clinical, with a palpable nodule at the level of T1 pulley. Conservative treatment, consisting in a nocturnal splint, is indicated before the age of two years old. After this age, or in case of failure of splinting, surgery will be needed. 相似文献
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Fernández-Vázquez JM Schenk-Palao J Fernández-Palomo J Camacho-Galindo J 《Cirugia y cirujanos》2003,71(6):469-474
Triphalangeal thumb is often thought to be a rare congenital abnormality; it has an incidence of 1 in 25,000 births. We reviewed 49 triphalangeal thumbs in 28 Mexico City patients at the Diaz Lombardo Hospital from 1974 to 1979, Shriners Hospital from 1979 to 1982, Instituto Nacional de Ortopedia from 1981 to 1982, and at the ABC Hospital from 1971 to 1998. A total of 21 patients (75%) had bilateral deformity. Patients were classified according to Dieter Buck-Gramcko system and Müller teratologic line. All were surgically treated and evaluated with Cheng graduation scale, finding good results in 48 patients (97%), fair results in one (3%), and no poor results. 相似文献
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Over a period of 9 years (1979-1988), more than 1000 patients have been seen in the Department of Hand Surgery with a tentative diagnosis of skier's thumb or a painful metacarpophalangeal of the thumb. Most injuries were treated conservatively, but 562 operations on the ulnar collateral ligament were done during this period. An X-ray Film was taken in all cases to exclude a fracture. The indications for an operation depend on the clinical symptoms. Swelling, pain just over the ulnar collateral ligament, and instability of the joint with a widening of the ulnar aspect of the joint of more than 30 degrees in comparison to the other hand are typical clinical symptoms, which together with the widening in the flexion position, prove a rupture of the collateral ligament. As part of our standard examination we take X-ray films of the hand in two projections to exclude a fracture, followed by abducted stress views in comparison to the other side. The best results were obtained when surgical therapy was performed within the first 8 days. Fractures of the base of the proximal phalanx of the thumb were operated on by pin wire fixation of the bone fragment in the anatomically correct position along with temporary transarticular pin wire arthrodesis. In ligamentous ruptures, periostal sutures together with a temporary arthrodesis were carried out. Old injuries without sufficient regeneration of the ligament and capsule necessitated plastic surgery using the long pulmar tendon or a PDS wire. In each case the joint was immobilized with a cast for 5-6 weeks, followed by active physiotherapy. 相似文献
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Mallet thumb 总被引:1,自引:0,他引:1
The uncommon injury of mallet thumb is described, with four case reports. In diagnosis the condition must be distinguished from dropped thumb. Operative treatment is advised which, in this small series, gave excellent results. 相似文献
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The hand is the main tactile sensory organ and is uniquely designed for fine motor activities. Any deviation from the normal architecture or limitation from a painful condition may lead to disability. Rheumatoid arthritis (RA) is fundamentally an inflammatory disease of the soft tissues. Deformities of the thumb arise from abnormal stretching of ligament and capsular structures as well as from ruptures and subluxations of the tendons. This article provides an overview of the types of deformities associated with, and surgical management of, RA of the thumb. 相似文献