手指转位术治疗复杂拇指多指畸形

Clinical application of the finger translocation in treating complicated polydactyly

目的 探讨应用手指转位术治疗复杂拇指多指畸形的临床应用.方法 2012年9月-2016年10月,对12例复杂拇指多指畸形的患儿进行手术治疗,通过详细的术前查体,结合X线检查后制定手术方案,将发育较好的尺（桡）侧指体移位至发育较好的桡（尺）侧掌骨上,重建掌指关节,开大虎口,再造拇指,达到同时兼顾外观和功能的目的.结果 12例均获随访6~36个月,平均24.6个月,除1例术后皮瓣尖端部分坏死,经换药愈合,其余伤口均Ⅰ期愈合,再造拇指对掌对指功能良好.结论 手指转位术能充分利用发育较好的手指重新再造拇指,兼顾了拇指的功能和外形,是治疗复杂拇指多指畸形的一种有效方法.

Objective To observe the clinical application of reforge thumb by using the thumb translocation to treat complicated polydactyly. Methods To get both satisfied outward appearance and function, using the finger translocation technique reforge the thumb by detailed physical examination and X-ray before operation on twelve complicated polydactyly cases from September 2012 to October 2016. Well developed ulnar（radial） finger could be translocated to radial（ulnar） metacarpal bone head to reforge a new metacarpophalangeal joint by repairing capsula ligament and broadening the ＂tiger mouth＂. Results All the cases were fallowed up for 6 to 36 months by the average 24.6 months, the flap and function were satisfied except one case, which apical flap partial necrosis and recurred by changing dress. Conclusion It is an effective method to treat complicated polydactyly by using the finger translocation to reforge the thumb, which can get both satisfied outward appearance and function.