CAJ | 학술논문

目的评价Bilhaut-Cloquet术治疗先天性复拇指畸形的临床效果,探讨分析其常见并发症的原因.方法 2006年至2009年,对15例先天性复拇指畸形患儿分别采用经典和改良Bilhaut-Cloquet术进行治疗,随访观察术后并发症并对疗效进行评价.结果术后15例获得1～20个月的随访,平均6个月.参照Kawabata评分标准:采用经典Bilhaut-Cloquet术者5例,优1例,良3例,差1例;采用改良Bilhaut-Cloquet术者10例,优6例,良3例,差1例.两组中指甲畸形明显者9例,瘢痕挛缩、增生者5例.结论 Bilhaut-Cloquet术是治疗复拇指畸形的有效治疗术式,适合于Ⅰ型对等型多拇;Ⅱ型以上的多拇采用改良Bilhaut-Cloquet术更有利于指间关节(IP)关节活动度的恢复.除了重视关节活动度、稳定性和侧偏畸形的矫正外,指体外观尤其是指甲的精确重建应当得到进一步的重视.
목적 평개Bilhaut-Cloquet술치료선천성복무지기형적림상효과,탐토분석기상견병발증적원인.방법 2006년지2009년,대15례선천성복무지기형환인분별채용경전화개량Bilhaut-Cloquet술진행치료,수방관찰술후병발증병대료효진행평개.결과 술후15례획득1～20개월적수방,평균6개월.삼조Kawabata평분표준:채용경전Bilhaut-Cloquet술자5례,우1례,량3례,차1례;채용개량Bilhaut-Cloquet술자10례,우6례,량3례,차1례.량조중지갑기형명현자9례,반흔련축、증생자5례.결론 Bilhaut-Cloquet술시치료복무지기형적유효치료술식,괄합우Ⅰ형대등형다무;Ⅱ형이상적다무채용개량Bilhaut-Cloquet술경유리우지간관절(IP)관절활동도적회복.제료중시관절활동도、은정성화측편기형적교정외,지체외관우기시지갑적정학중건응당득도진일보적중시.
Objective To evaluate the clinical outcomes of Bilhaut-Cloquet surgical procedure for the treatment of thumb duplication, and investigate the causes of common complications. Methods Bilhaut-Cloquet procedure and modified Bilhaut-Cloquet procedure were carried out in 15 children with congenital thumb duplication during 2006 to 2009. The patients were follow-up postoperatively to observe any complications and assess the results using Kawabata evaluation criterion. Results The 15 children were follow-up for 1 to 20 months (6 months on average) postoperatively. According to Kawabata evaluation criterion, the Bilhaut-Cloquet procedure achieved excellent results in 1 cases, good in 3 cases, and poor in 1 cases. Modified Bilhaut Cloquet procedure achieved excellent results in 6 cases, good in 3 cases, and poor in 1 case. Nine cases had apparent nail deformity and 5 cases were accompanied by cicatricial contracture and hyperplasia. Conclusion The Bilhaut-Cloquet technique is an effective procedure for the treatment of thumb duplication, especially suitable for type Ⅰ thumb duplication. Modified Bilhaut-Cloquet procedure is more conducive to the recovery of IP range of motion when used in type Ⅱ or more severe thumb duplication. Besides joint range of motion, stability, and correction of lateral deviation, appearance of the thumb especially accurate nail restoration should acquire more attention.