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先天性多指畸形的分类及手术治疗 |
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余希临 刘海峰 成琦 黄茂华 高玉美
【摘要】 目的 介绍先天性多指畸形的分类,讨论其治疗方法。方法 对197例先天性多指畸形的临床资料进行回顾性分析。结果 轴前型多指根据Wassel法进行分型,Ⅳ型最多,占46.71%;Ⅱ型占23.03%;Ⅶ型占5.92%。轴后型多指根据Stelling-Twrek法进行分型,Ⅱ型占75.0%,Ⅰ型占16.67%,Ⅲ型占8.33%。均手术治疗,术后随访1~7年,除12例出现并发症外,其余病例效果满意, 效果满意率为93.90%。结论 多指的临床分型对手术治疗有重要的指导意义,根据分型选择最佳手术时机,对于赘生指和末节指骨型多指应尽早手术,恢复手的外形。近节指骨型或掌骨型多指手术年龄可推迟至1岁6个月以后。手术的重点是矫形和功能重建。 【关键词】 多指畸形 分类法 外科手术
Classification and Treatment for Congenital Polydactyly Deformity
YU Xilin, LIU Haifeng, CHEN Qi, et al. Dept. of Orthopedics, Wuhan Childrens Hospital, Wuhan 430016
【Abstract】 Objective To discuss the classification and treatment for congenital polydactyly. Methods The clinical materials of 197 cases with congenit al polydactyly were analysed retrospectively. ResultsPreaxial polydactyly was classified according to Wassels classification, most of them belonged to type Ⅳ(46.71%),type Ⅱ(23.03%), type Ⅶ(5.92%). Postaxial polydactyly was classified according to Stelling-Twreck's classification( type Ⅱ75.0%, typeⅠ16.67% and typeⅢ8.33%). All cases were followed up for 1-7 years wi th satisfactory results, except 12 cases had complications. Conclusions The clinical classification is important to the treatment and selection the timing of operation. The patients with polydactyl ism or distal phalanx type should be operated on in early stage. It is suggested to postpone the operation over 1.5 years of age on cases with proximal pha lanx type or matacarpal type. The operation aims to rehabilitate the form and fu nction of the hand. 【Key words】 Polydactyly Classification Surgical operation
多指畸形是最常见的先天性手畸形,既往临床上治疗简单,以小手术对待。随着认识的提高,要求多指的手术治疗除美容外,还需功能重建。而多指畸形的变化较大,需要根据多指的类型制订有针对性的手术方案。现将我院1992~1998年治疗197例多指畸形的体会报告如下。
临床资料 一、一般资料 本组197例,男133例,女64例。年龄最小6天,最大10岁,平均年龄1岁6个月。右手104例,左手69例,双侧24例,其中合并手、足3侧畸形1例,合并4侧畸形2例。轴前型多指152例,轴后型多指36例,属中央型的9例。合并拇指内翻畸形5例,蟹状手6例,足多趾18例,拇指发育不全11例,镜手畸形1例。 [1] [2] 下一页 上一个医学论文: B超早期诊断新生儿脊髓栓系综合征 下一个医学论文: 小儿延迟性脾破裂的诊断与治疗
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