儿童Ⅵ-Ⅶ型复拇指畸形的显微外科组合治疗

Microsurgery treatment for Wassel type Ⅵ～Ⅶ thumb duplication

目的探讨儿童先天性特殊类型Ⅵ～Ⅶ型复拇指畸形的显微外科组合治疗方法。方法 2009年3月-2016年7月,采用赘生拇指指血管神经蒂的指移位矫形主干拇指10例,其中9例赘生拇指掌骨一同切除,并重建拇内收肌止点。结果 10例术后均获3～24个月随访,外形改善,骨轴线正常,矫形拇指指体接近正常指,矫形拇指对指及外展功能正常。虎口开大4～6cm,矫形拇指感觉正常。结论通过显微外科的组合方法将主干拇指和赘生拇指合二为一,恢复矫形拇指和虎口外形及功能,是矫正先天性Ⅵ～Ⅶ型复拇指畸形的一种有效途径。

Objective To evaluate the microsurgery treatment of Wassel type Ⅵ-Ⅶ thumb duplication. Methods From March 2009 to July 2016, ten cases with vascular nerve pedicle was applied to the residual digit for the reconstruction of the deformity thumb. In 9 out of-the l0 cases, supernumerary thumbs and metacarpal was both cut, and reconstructed the insertion of adductor pollicis. Results The postoperative follow-up was 3 to 24 months, the reconstruct thumb had marked improvement in appearance and recovery, and near normal in thumb axis, sensation, thumb-to-digit, and thumb abduction. The width of the first web space was 4-6 cm. Conclusion Combing the skin flap of the deleted thumb with the residual thumb is the proper method to treat Wassel type Ⅵ-Ⅶ thumb duplication.