先天性缩窄带综合征并指畸形的临床分型及治疗策略

Clinical classification and treatment strategy of syndactyly in the congenital constriction band syndrome

目的研究和分析先天性缩窄带综合征并指畸形的临床特点，建立新的临床分型系统并确立相关的治疗策略。方法回顾性分析2002年2月至2009年8月经治疗的先天性缩窄带综合征并指畸形40例，以临床形态特点为依据，结合既往已有的Patterson分型、Blauth分型，将具有相同或相似解剖形态学改变的归为同一类型，归纳出新的分型特点。新的分型系统包括：Ⅰ型（n、IB），Ⅱ型，Ⅲ型（ⅢA、ⅢB、ⅢC、ⅢD、ⅢE），Ⅳ型，Ⅴ型，以及Ⅵ型。结果在本分型系统中，包括了既往Patterson分型、Blauth分型系统中的所有内容，同时增加了新的内容，如ⅢC、ⅢD、ⅢE、Ⅳ型、Ⅴ型，并将Blauthm型（Ⅰ型）分为两个亚型。结论新分型系统详细、全面地涵盖了先天性缩窄带综合征并指畸形的临床形态学特征，为合理选择手术治疗策略提供了基础。

Objective To review and analyze the clinical characteristics of syndactyly in the congenital constriction band syndrome, and offer a new classification system and treatment strategy. Methods Forty cases of syndactyly in the congenital constriction band syndrome treated by the authors between February 2002 and August 2009 were reviewed. Based on the clinical and morphologic characteristics, they were classified into six types： type Ⅰ, Ⅱ, Ⅲ, Ⅳ, Ⅴ and type Ⅵ. Type Ⅰ was divided into subtype IA and subtype IB, and type Ⅲ into subtype ⅢA to subtype ⅢE. Results The new classification system covered all contents of Patterson classification and Blauth classification, and meanwhile added type ⅢC, ⅢD, ⅢE, type IV and type V into the new system. Blauth type Ⅲ （type Ⅰ in new classification） was divided into type IA and type IB. Conclusion The new classification system covers clinical and morphologic characteristics more comprehensively, and offers a basis for surgical treatment options with syndactyly in the congenital constriction band syndrome.