复拇指畸形治疗中骨关节的处理

目的 报告复拇指畸形治疗中骨关节的处理疗效.方法 对52例65指复拇指畸形的患者,针对不同类型,采用截骨关节矫形、侧副韧带肌腱修复重建和指套状瓣修复存留指等方法进行治疗,术后随访观察拇指关节外形和功能恢复情况.结果 术后随访到38例47指,随访时间为5个月至9年,其中4例4指术后出现不同程度的畸形,经过2次手术后,得到良好矫正.其余43指,术后拇指外形和功能均得到了明显改善,优良率为91.5%.结论 复拇指畸形治疗中,关节的处理是矫形手术的关键,如处理不当会导致术后继发性畸形.

Management of bone and joint in the treatment of thumb duplication

Objective To report the methods of managing bone and joint in the treatment of thumb duplication deformities and its clinical outcome. Methods Sixty-five thumb duplication deformities in 52cases were involved in this study.According to the phenotypes of the deformities corrective osteotomy.arthroplasty,collateral ligament reconstruction and wrap-around flap from the resected thumb to repmr the preserved one were conducted.Postoperatively the appearance and funetion of the thumb were evaluated at follow-up.Resuits Forty-seven thumbs of 38 cases had sufficient follow-up.Follow-up period ranged from 5 months to 9 years.Various degrees of deformity was seen in 4 cases that required secondary surgery.Remarkable improvement of the appearance and function was observed in the rest 43 thumbs.The overall satisfactory rate was 91.5%. Conclusions Appropriate management of the bone and ioint is critical in the treatment of thumb duplication.Improper operations could lead to secondary deformity.