Ⅳ型复拇指初次术后畸形的矫治

Deformity correction after first surgery of type IV thumb duplication

目的探讨小儿WasselⅣ型复拇初次术后畸形的矫正方法。方法自2002年2月～2011年12月Ⅳ型复拇初次术后残留畸形35例患者(37指),以McBride为基本理论依据治疗掌指关节软组织畸形,对于掌骨头关节面偏斜者,行掌骨头近端"V"形截骨。通过多个"Z"样皮瓣可矫正拇指桡侧软组织缺损。结果 35例37指,术后进行6个月～5年随访,按TAM评定法优良率为100%,拇指外形及功能均取得满意效果。结论Ⅳ型复拇初次术后畸形通过良好的手术设计及方法仍然可取得较好疗效。

Objective To explore the postoperative deformity correction methods after the first surgery of Wassel type Ⅳ thumb duplication. Methods 35 children with 37 thumbs, who received the first surgery of type Ⅳ thumb duplication from February 2002 to December 2011 were selected. Taking McBride as the basic theoretical basis, the soft tissue malformations of metacarpophalangeal joint were treated. For patients with deflected metacarpal bone articular surface, the ＂V＂ shaped osteotomy of proximal metacarpal bone was conducted. Multiple ＂Z＂ shaped flap could correct the radial soft tissue defects of thumbs. Results The 35 children with 37 thumbs were followed up for 6 months to 5 years. According to the TAM rating method, the excellent and good rate was 100%, and both thumb appearance and function achieved satisfactory results. Conclusion Through good surgical design and methods, the postoperative deformity correction after the first surgery of type IV thumb duplication can still acquire favorable efficacy.