巨趾畸形12例临床分析

目的 总结巨趾畸形的临床特点和手术疗效.方法 回顾性分析12例巨趾畸形患者的临床资料.共12例(13足)患者,其中男性8例,女性4例,平均年龄4.6岁.均在出生时被发现畸形.多趾巨大畸形患者多于单趾畸形的患者,胫侧足趾好发.对应的前足均粗大.巨趾的趾骨均粗长,部分对应的跖骨粗长.术中见所有患者均有皮下脂肪过度增生,侵犯骨间肌和关节囊.足部神经和分支无明显增粗,无脂肪浸润.手术包括软组织缩容、骺阻滞、截趾、神经切断再吻合等.结果 7例患者获得随访,随访时间平均25.6个月.根据自行制订的分级标准进行功能评定:优2例,良2例,中3例.结论 手术治疗巨趾畸形有效,应重视手术适应证、手术时机和术式的选择.

Digital gigantism of the foot: a clinical study of 12 cases

OBJECTIVE: To summarize the clinical characteristic and outcome of digital gigantism of the foot. METHODS: Retrospectively analyze the clinical documents of cases of digital gigantism of the foot. Twelve 12 cases with 13 feet in this study included 8 male and 4 female with an average 4.6-years-old. All the deformities were found at birth. Multiple toes involved were more than single toe, and tibial toe involved more than fibular. Forefoot was enlarged. All the phalanges involved and partial metatarsal bones were enlarged. Marked increase in subcutaneous fat was found in all cases in the operation which infiltrated interossei and articular capsules. The appearance of the nerves and its branches in the foot were normal and fat infiltrating was not discovered. The operation types included debulking, epiphyseal arrest, amputation, nerve stripping and anastomosis. RESULTS: Seven cases were followed up with mean periods 25.6 months. Functional evaluation according to a criterion formulated by author revealed a result of 2 excellent, 2 good and 3 fair. CONCLUSIONS: Digital gigantism of the foot is an uncommon congenital deformity of the foot characterized by overgrowth of both the soft-tissue and the osseous elements of the enlarged toe and forefoot. Surgical treatment is the unique method, and the goal is to reduce the size of the foot to allow fitting regular shoes and walking readily. There are several types of operations which to be chosen. The indication, the timing of operative intervention and the selection of operation type should be paid more attention.