撑开式植骨加屈伸指肌腱调整治疗复拇畸形

Application of distraction bone graft and flexor extensor tendon adjustment in the treatment of thumb duplication deformity

目的探讨撑开式植骨加屈伸指肌腱调整技术用于治疗复拇畸形的疗效。方法自2017年3月至2019年10月我科收治17例17指复拇畸形患者。Ⅱ型7例,Ⅲ型2例,Ⅳ型8例。先采用屈伸肌腱松解或将去除指体的屈伸肌腱转移至指体的指间关节尺侧,并用去除指体的指骨对其尺侧拇指近节指骨颈下行撑开式植骨,实现骨性矫正配合肌腱调整,共同矫正拇指力线,达到矫正指间关节尺偏畸形的目的。结果术后17例患者均获得随访,平均时间为12个月。随访结果采用Tada制定标准评价:优12指,良5指。结论采用撑开式植骨加屈伸肌腱调整治疗复拇畸形,疗效满意。

Objective To investigate the effect of distraction bone graft and flexor extensor tendon adjustment in the treatment of thumb duplication deformity.Methods From March 2017 to October 2019,17 patients with thumb duplication deformity were treated in our department.There were 7 cases of typeⅡ,2 cases of typeⅢand 8 cases of typeⅣ.Firstly,the flexor and extensor tendons were released or transferred to the ulnar side of the interphalangeal joint.The phalanges of the fingers were removed to support the distraction bone graft of the proximal phalanx neck of the ulnar thumb,and bone correction and tendon adjustment were carried out to correct the thumb force line and achieve the purpose of correcting the ulnar deviation of the interphalangeal joint.Results All the 17 patients were follow-up for an average of 12 months.The follow-up results were evaluated by Tada criteria,and there were excellent in 12 fingers and good in 5 fingers.Conclusion The treatment of thumb duplication deformity with distraction bone graft and flexor extensor tendon adjustment is effective.