自行设计Mini-Ilizarov外固定架在虎口挛缩中的应用

Application of the self-designed Mini-Ilizarov external fixator in the treatment of the first web space contracture

目的评价自行设计的Mini-Ilizarov外固定架在虎口挛缩中的应用及治疗效果。方法自2015年10月至2018年8月我院收治虎口挛缩患者6例,应用自行设计组装的Mini-Ilizarov外固定架固定,术后通过调整装置,缓慢撑开并矫正虎口挛缩。随访采用Tada评分系统,比较术前、术后虎口挛缩矫正效果及拇指对掌,外展、握持及握拳功能恢复情况。结果术后6例患者均获得随访,手术前、后虎口挛缩均得到改善,外观矫正,且拇指对掌,外展等功能得到一定程度恢复,但其中2例因外固定架固定时间不够,随访中发现轻度反弹复发。结论使用自行设计的Mini-Ilizarov外固定架固定,结合改进的瘢痕松解术及恰当的植皮、皮瓣转移覆盖术治疗,可以有效治疗及改善虎口挛缩,在一定程度上恢复拇指相关功能,且不易复发。

objective To evaluate the application and clinical efficacy of the self-designed Mini-Ilizarov external fixator in the trealment of the first web space contracture.Methods From October 2015 to August 2018,6 patients with the first web space contracture were treated in our hospital.They were fixed with the self-designed Mini-lizarov external fixator.After operation,the first web space contracture was slowly opened and corrected by adjusting the device.Tada score system was used in the follow-up to compare the efficacy of correction of first web space contracture and the recovery of thumb opposition,abduction,grip and fist function before and after operation.Results All the 6 patients were follow-up.The first web space contracture was improved before and after the operation.The appearance was corrected.The funetion of thumb opposition and abduction was recovered to a certain extent.However,2 cases were found to have mild rebound and relapse due to insufficient fixation time of external fixator,Conclusion Using the self-designed Mini-llizarov external fixator,combined with improved scar release,proper skin grafting and skin flap transfer and covering,can effectively treat and improve the first web space contracture,restore the thumb related function to a certain extent,and is not easy to relapse.