微型外固定器虎口开大术

Treatment of first web space contracture using mini-external fixator

目的探讨微型外固定器辅助手术治疗虎口挛缩的手术方法及临床效果。方法 2007年9月-2010年12月,采用微型外固定器辅助手术对临床11例病人共13侧患肢虎口实施反复3次开大手术,并记录末次开大程度。其中右手8侧,左手5侧,重度挛缩9侧,中度挛缩4侧。结果所有手术均顺利完成,随访3-8个月,平均5个月,拇指外展角度平均增加30°,拇指指间关节尺侧与示指掌指关节桡侧之间距离平均增加3cm。术后1例发生针道感染,1例出现第一腕掌关节半脱位。结论采用微型外固定器辅助手术开大虎口安全可行,临床效果显著。

Objective To study the surgical treatment of first web space contracture using mini-external fixator and its clinical outcome.Methods Eleven patients with first web space contracture at 13 sides of the hands underwent 3 times of mini-external fixator-aided operation from September 2007 to December 2010.The breadth of first web space contracture at the last operation was recorded.First web space contracture occurred at 8 sides of the right hand and at 5 sides of the left hand,severe and moderate first web space contracture occurred at 9 and 4 sides of the hand,respectively.Results All operations were successful.The patients were followed up for 3-8 months（mean 5 months）.The mean thumb adduction was increased 30 degrees.The distance between the radial side of metacarpal phalangeal joint of the index finger and the ulnar side of interphalangeal joint of the thumb was increased 3cm.Pin site infection occurred in 1 patient and semidislocation of the first carpometacarpal joint occurred in 1 patient after operation.Conclusion Mini-external fixator-aided surgery is a safe and effective procedure for first web space contracture with rather good clinical outcomes.