中华手外科杂志
中華手外科雜誌
중화수외과잡지
CHINESE JOURNAL OF HAND SURGERY
2012年
4期
206-210
,共5页
田文%赵俊会%田光磊%李淳%侯春梅%杨勇%刘波%朱瑾%王凌宇%薛云皓%刘春玲
田文%趙俊會%田光磊%李淳%侯春梅%楊勇%劉波%硃瑾%王凌宇%薛雲皓%劉春玲
전문%조준회%전광뢰%리순%후춘매%양용%류파%주근%왕릉우%설운호%류춘령
Poland综合征%手畸形,先天性%并指(趾)%分型%治疗策略
Poland綜閤徵%手畸形,先天性%併指(趾)%分型%治療策略
Poland종합정%수기형,선천성%병지(지)%분형%치료책략
Poland syndrome%Hand deformities,congenital%Syndactyly%Classification%Treatment strategy
目的 总结和探讨Poland综合征手部畸形的临床形态学特征及治疗策略.方法 回顾总结2000年2月至2011年8月由我科诊治的Poland综合征患者63例,系统归纳其手部畸形的形态学特点,依据畸形手形态受影响的程度进行分型,分为典型型和其他型两大类,典型型分为Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ型,其他型分为Ⅰ、Ⅱ、Ⅲ型.并总结不同类型Poland综合征畸形手的生长发育、手指并连、X线片表现、合并畸形及功能损害等特点.根据上述分型,对其中56例进行外科治疗,并对各个类型的畸形手的治疗策略进行总结和归纳.结果 术后对所有手术治疗患者进行随访,时间为6～18个月,平均10.5个月.分指成功率达100％,手术后主要残留指蹼粘连和瘢痕挛缩等问题.除并指外的其他畸形,如短指、缺指、肢体短小、乳房发育不良等,目前仍无法有效治疗手段.结论 Poland综合征畸形手形态学改变复杂、多样化,本研究对Poland综合征手畸形的分型,基本反映了Poland综合征手部畸形的形态学改变特点,依据此分型对畸形手进行手术治疗,获得一定的临床效果,伴发畸形仍需进一步治疗.
目的 總結和探討Poland綜閤徵手部畸形的臨床形態學特徵及治療策略.方法 迴顧總結2000年2月至2011年8月由我科診治的Poland綜閤徵患者63例,繫統歸納其手部畸形的形態學特點,依據畸形手形態受影響的程度進行分型,分為典型型和其他型兩大類,典型型分為Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ型,其他型分為Ⅰ、Ⅱ、Ⅲ型.併總結不同類型Poland綜閤徵畸形手的生長髮育、手指併連、X線片錶現、閤併畸形及功能損害等特點.根據上述分型,對其中56例進行外科治療,併對各箇類型的畸形手的治療策略進行總結和歸納.結果 術後對所有手術治療患者進行隨訪,時間為6～18箇月,平均10.5箇月.分指成功率達100％,手術後主要殘留指蹼粘連和瘢痕攣縮等問題.除併指外的其他畸形,如短指、缺指、肢體短小、乳房髮育不良等,目前仍無法有效治療手段.結論 Poland綜閤徵畸形手形態學改變複雜、多樣化,本研究對Poland綜閤徵手畸形的分型,基本反映瞭Poland綜閤徵手部畸形的形態學改變特點,依據此分型對畸形手進行手術治療,穫得一定的臨床效果,伴髮畸形仍需進一步治療.
목적 총결화탐토Poland종합정수부기형적림상형태학특정급치료책략.방법 회고총결2000년2월지2011년8월유아과진치적Poland종합정환자63례,계통귀납기수부기형적형태학특점,의거기형수형태수영향적정도진행분형,분위전형형화기타형량대류,전형형분위Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ형,기타형분위Ⅰ、Ⅱ、Ⅲ형.병총결불동류형Poland종합정기형수적생장발육、수지병련、X선편표현、합병기형급공능손해등특점.근거상술분형,대기중56례진행외과치료,병대각개류형적기형수적치료책략진행총결화귀납.결과 술후대소유수술치료환자진행수방,시간위6～18개월,평균10.5개월.분지성공솔체100％,수술후주요잔류지복점련화반흔련축등문제.제병지외적기타기형,여단지、결지、지체단소、유방발육불량등,목전잉무법유효치료수단.결론 Poland종합정기형수형태학개변복잡、다양화,본연구대Poland종합정수기형적분형,기본반영료Poland종합정수부기형적형태학개변특점,의거차분형대기형수진행수술치료,획득일정적림상효과,반발기형잉수진일보치료.
Objective To review and analyze the clinical morphologic characteristics of the hand deformity in Poland syndrome,and establish a new classification system and treatment strategy. Methods Sixty-three cases with Poland syndrome treated by the authors between February 2000 and August 2011 were evaluated retrospectively.The clinical morphologic characteristics of the hand deformity were systemically analyzed.Based on the severity degree of morphologic deformity,the Poland hand was classified into typical type and atypical type.Typical type was sub-classified into type Ⅰ,type Ⅱ,type Ⅲ,type Ⅳ and type Ⅴ,and atypical type was sub-classified into type Ⅰ,type Ⅱ and type Ⅲ.The deformed hands in each type were also summarized with respect to growth and development,syndactyly,X-ray features and impairment of functions.56 cases of them were treated surgically under the guidance of the new classification,and a new strategy for surgical treatment was established. Results A follow-up of 10.5 months on average (range from 6 to 18 months) postoperatively showed that the success rate of interdigital syndactyly welease was 100％.The major postoperative problems included scar contracture and web adhesion.Currently there were still no ideal methods for treatment of associated anomalies(such as short fingers,hypoplasia of forearm and upper arm,aplasia of digits,breast hypoplasia).Conclusion The hand deformities in Poland syndrome are complicated with multiple manifestations.The new classification system covers clinical and morphologic characteristics comprehensively,and offers a basis for options of surgical treatment of the deformed hand.The associated anomalies still need to be treated in the future.
