先天性拇指疾病的疗效分析

Analysis of treatment outcome of congenital thumb disorders

目的 介绍先天性拇指疾病的治疗效果。方法 1 988年起 ,对 56例先天性拇多指畸形 ,先天性拇板机指及先天性拇巨指症进行手术治疗。采用拇指赘生指切除、副指皮瓣转移 ,多拇残端修整术治疗拇多指畸形 ;巨指截指及整形术治疗巨指症 ;增厚狭窄腱鞘切除术治疗先天性拇板机指。结果 术后随访 2～ 1 0年。 (1 )先天性拇指多指畸形 :主干拇指外形改善 ,拇外展充分 ,对指功能良好。 (2 )拇指板机指 :拇指伸屈自如 ,发育满意。 (3 )先天性巨指症 1例 :示、中指巨指切除 ,拇指远节截除 ,近节缩短整形 ,术后外形欠佳。结论 先天性拇指多指畸形应根据具体情况选择手术方式 ,以改善畸形、恢复拇指功能。先天性板机指明确诊断后手术疗效佳。先天性巨指症采用截指方法较为理想。

Objective To introduce the treatment outcome of the congenital thumb disorders.Methods From 1988, 56 cases of congenital thumb polydactyly, trigger thumb and macrodactyly were treated surgically. Excision of polydactylism,transfer of accessory finger flap and repair of finger stump were done for polydactyly; finger amputation and plastic surgery for macrodactyly; resection of thickened and stenosis tendon sheath for trigger thumb. Results The follow up ranged from 2 to 10 years postoperatively. (1) Congenital polydactyly: the appearance of the thumb was satisfactory ,with good function of abduction and pinch.(2) Trigger thumb : the flexion and extension functioned well with satisfactory growth.(3) Macrodactyly: index and middle finger,and the distal part of thumb were resected, while the proximal part was amputated, but the postoperative appearance was not satisfactory. Conclusions Surgical procedure should be chosen appropriately in treatment of the congenital thumb disorders for improvement of deformity and functional restoration. The trigger thumb be treated surgically when diagnosis was made. The congenital macrodactyly be amputated accordingly.