目的 探讨软组织重建治疗儿童蟹钳指畸形的临床效果.方法 2019年1月—2022年12月对25例蟹钳指畸形或蟹钳指畸形术后出现"Z"形畸形患儿进行软组织重建治疗,观察术后1年Tada评分、并发症发生情况.结果 术后1年,25例患儿的Tada评分优16例(64%),良8例(32%),差1例(4%).术后1年Peds QL评分(92.74±9.52)高于术前(79.25±7.43),比较差异有统计学意义(P＜0.001).指间关节伸直障碍、骨折愈合延迟各发生1例,并发症总发生率8%.结论 软组织重建治疗儿童蟹钳指畸形,患儿无需经历一期切除重复拇指,二期行截骨矫形手术或者切除多指的多次手术,只需一次手术就完成蟹钳指截骨矫形,具有治疗周期短、患儿痛苦少、家庭经济成本低,且能显著提升患儿生存质量,临床效果满意等优点.
Objective To investigate the clinical effect of soft tissue reconstruction in the treatment of crab-claw finger deformity in children.Methods From January 2019 to December 2022,soft tissue reconstruction was performed in 25 patients with crab-claw finger deformity or"Z-shaped"deformity after surgery,and Tada score and complications were observed one year after surgery.Results One year after surgery,16 of 25 children had excellent Tada scores(64%),8 of 25 had good scores(32%),and 1 had poor score(4%).The Peds QL score 1 year after operation(92.74±9.52)was significantly higher than that before operation(79.25±7.43),and the difference was statistically significant(P＜0.001).Dysextension of interphalangeal joint and delayed fracture healing occurred in 1 case,the total complication rate was 8%.Conclusions In the treatment of crab-claw finger deformity and soft tissue reconstruction,children do not need to undergo one-stage resection of the repetitive thumb,second-stage osteotomy and orthopedic surgery or multiple operations to remove extra fingers,and just only one operation is needed to complete the osteotomy and orthopedic surgery of crab-claw finger,which has the advantages of short treatment cycle,less pain for children and low economic cost for families.It significantly improves the quality of life of children and has satisfactory clinical effects.
蓝吉斌;南国新;李志星
南宁市第一人民医院小儿外科(广西南宁 530016)重庆医科大学附属儿童医院(重庆 400015)
软组织重建;蟹钳指畸形;修复外科手术
soft tissue reconstruction;crab-claw finger deformity;reconstructive surgery procedures
《广州医药》 2024 (001)
48-53 / 6
广西壮族自治区卫生健康委员会自筹经费科研课题(Z-A20221134)
10.3969/j.issn.1000-8535.2024.01.008
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