先天性多发手部关节挛缩的分类及治疗

Classification and treatment of hand deformities of arthrogryposis multiplex congenita: a clinical analysis

目的探讨先天性多发手部关节挛缩的分类方式及治疗效果。方法自2010年1月至2018年1月我们共诊治72例(拇指144指,其他指556指)先天性多发手部关节挛缩患者,将患者按不同病理解剖特点分为6类,并按不同分类进行相应治疗。结果术后60例患者(拇指93指,其他指296指)获得随访,时间为1-83个月,平均16.2个月。患指治疗效果评价总体优良率达到87.4%(340/389),其中拇指优良率为76.3%(71/93),其他指优良率为90.9%(269/296)。所有植皮均成活,挛缩复发1例1指。结论本组患者治疗后患指活动度满意,治疗安全性高,因此根据本文所述的分类方法对相应类型的患者采取对应的治疗,能够使先天性多发手部关节挛缩患者获得良好的疗效。

Objective To explore the classification and treatment efficacy of hand deformities of arthrogryposis multiplex congenita. Methods From January 2010 to January 2018, 72 patients (144 thumbs, 556 other fingers) with hand deformities of arthrogryposis multiplex congenita were treated. The patients were divided into 6 groups according to their different pathological and anatomical characteristics and treated accordingly. Results Postoperatively, 60 patients (93 thumbs, 296 other fingers) were follow-up for 1 to 83 months, with an average of 16.2 months. The overall excellent and good rate of the clinical efficacy of the affected fingers was 87.4%(340/389), of which 763%(71/93) was for the thumbs and 90.9%(269/296) for the other fingers. All skin grafts survived and 1 finger recurred. Conclusion All the patients in this group have satisfactory finger movement and high safety after treatment. Therefore, according to the classification method described in this paper, the patients with hand deformities of arthrogryposis multiplex congenita can be treated accordingly, which can achieve good results.