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1.
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
2.
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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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
6.
对197例拇指Ⅲ~Ⅳ级缺失者,采用自体姆甲瓣游离移植包裹冷冻异体手指的复合组织(骨、关节、肌腱、腱鞘)再造拇指200指。笔者认为冷冻能降低异休手指组织的抗原性,术前、后不用抑制排异反应的制剂与激素,无急性排异反应发生。手术成功率96.4%,异体手指存活率91.5%。术后3个月感觉恢复,测定对掌功能144例,优良率为91.6%。平均随访时间4年5个月,部分病例远期出现异体骨吸收及关节变性,可能与骨片未镶嵌好,术后活动过早及慢性排异有关;但主要是移植组织未及时恢复神经血管的营养支配有关。为此取■甲瓣时内附着趾关节2块骨片,挖去异体指骨内骨髓,植入自体新鲜红骨髓及松质骨,有利于血管长入异体骨及促进宿主对其爬行替代。提出合理设计供足阳趾胫侧的保留皮瓣,尽量维持趾长度,供皮瓣区中厚皮片植皮,保存第1背侧跖骨肌及跗内外侧血管及足背皮神经,可减少足的并发症。 相似文献
7.
Türker KS Yeo PL Gandevia SC 《Experimental brain research. Experimentelle Hirnforschung. Expérimentation cérébrale》2005,165(1):37-43
As visual guidance of facial movements is impossible, accurate movements for speech and mastication require an established body image that is formed via the information from mechanoreceptors in the skin, mucosa, periodontium, and proprioceptors in the facial and masticatory muscles and in the jaw joints. In this study we aimed to investigate how the acute deafferentation of lips and teeth alters the established image of lips, teeth and the thumb. We used a psychophysical method to determine whether the perceived sizes of the upper lip and front teeth change when the sensory input from the lips and front teeth is fully blocked. We also examined the perceived size of the thumb to test for acute interactions between the thumb and facial structures. Local anaesthetic blocking of upper lip and upper front teeth significantly increased the perceived size of the upper lip by as much as 100% (range 21–100%) in ten out of eleven subjects tested (overall mean 52%; p=0.001). The perceived size of the upper teeth also significantly increased by as much as 155% (range 30–155%) in eight of the eleven subjects during anaesthesia (overall mean 41%; p=0.035). When the region of anaesthesia was increased and both upper and lower teeth and lips were anaesthetised, the perceived size of the upper lip again increased, by 53% (p=0.040), but the change in perceived size of the upper front teeth (18%) was not significant (p=0.206). In both studies there was no change in perceived size of the thumb. The results illustrate the labile central interaction between sensory inputs and the importance of feedback from peripheral afferents in generating the subjective facial image. The timing, level, and area of anaesthesia may be important modifiers of these interactions. 相似文献
8.
T. E. Milner 《Experimental brain research. Experimentelle Hirnforschung. Expérimentation cérébrale》1986,62(1):99-110
Summary Control of velocity in rapid flexion movements of the interphalangeal joint of the thumb was investigated by examining movement trajectories and patterns of activity in the extensor pollicis longus (EPL) and flexor pollicis longus (FPL) muscles. Although velocity was controlled with considerable accuracy, it was not sensed with the same precision. Consistent errors were made when subjects attempted to match the peak velocities under conditions in which the relationship between muscle activity and joint acceleration had been altered, i.e. changing the angle from which movement was initiated or varying the load. Rather than relying on afferent feedback from peripheral sensory receptors for information about velocity during rapid movements, it is suggested that subjects were more likely to base their judgment of velocity on sensations evoked by the voluntary motor command. 相似文献
9.
用血清药理学方法观察毛茛提取液对家兔主动脉平滑肌细胞内钙的影响 总被引:2,自引:0,他引:2
目的:观察毛茛提取液含药血清对培养家兔主动脉平滑肌细胞内游离钙浓度的影响.方法:体外培养家兔主动脉平滑肌细胞(VSMC),用荧光指示剂INDO-AM负载细胞,灌胃给予不同浓度药物,观察不同稀释浓度含药血清及不同时相药物血清对由NE诱导细胞内游离钙浓度([Ca2 ]i)增加的影响.结果:毛茛提取液各含药血清组均能降低由NE诱发的细胞内[Ca2 ]i的升高.结论:毛茛提取液含药血清能减少VSMC细胞内[Ca2 ]i. 相似文献
10.