CAJ | 학술논문

目的探讨Ⅰ型和ⅡA型先天性分裂手畸形矫形手术的治疗效果.方法自2006年7月至2011年7月,对14例(17侧)Ⅰ型和ⅡA型先天性分裂手畸形患儿进行矫形手术,采用A1滑车重建掌深横韧带术和中央裂隙皮肤软组织整形,并对9侧ⅡA型分裂手进行虎口加深术.结果术后随访6～25个月,平均(17.0±4.2)个月.全部患手握拳和拇、示指持捏功能达优良；16侧患手屈、伸运动正常,1侧环指近指间关节(PIP)伸直减少25°；1侧示指轻度桡偏和旋转畸形.全部患儿家长对术后手外观感到满意.结论 Ⅰ型和ⅡA型先天性分裂手畸形通过A1滑车重建掌深横韧带和中央裂隙皮肤软组织整形术,可明显改善手的外观和功能.
목적 탐토Ⅰ형화ⅡA형선천성분렬수기형교형수술적치료효과.방법 자2006년7월지2011년7월,대14례(17측)Ⅰ형화ⅡA형선천성분렬수기형환인진행교형수술,채용A1활차중건장심횡인대술화중앙렬극피부연조직정형,병대9측ⅡA형분렬수진행호구가심술.결과 술후수방6～25개월,평균(17.0±4.2)개월.전부환수악권화무、시지지날공능체우량；16측환수굴、신운동정상,1측배지근지간관절(PIP)신직감소25°；1측시지경도뇨편화선전기형.전부환인가장대술후수외관감도만의.결론 Ⅰ형화ⅡA형선천성분렬수기형통과A1활차중건장심횡인대화중앙렬극피부연조직정형술,가명현개선수적외관화공능.
Objective To investigate the surgical treatment of type Ⅰ and type ⅡA congenital cleft hands and the clinical outcomes.Methods Between July 2006 and July 2011,17 cases (in 14 patients) of type Ⅰ and type ⅡA congenital cleft hands were surgically treated.The transverse metacarpal ligament was reconstructed with A1 pulleys along with soft tissue plasty in the central V-shaped cleft.Widening of the first web space was done in 9 cases of type ⅡA deformity.Results The postoperative follow-up period ranged from 6 to 25 months,the mean length being (17.0 ± 4.2) months for all cases.All wounds healed by first intention.The gripping and pinching function were good.Normal flexion and extension were achieved in 16 cases,while 25°extension lag of the proximal interphalangeal joint of the ring finger was noticed in one case.One index finger showed mild radial deviation and rotation.Parents of all 14 patients were satisfied with the postoperative appearance.Conclusion Transverse metacarpal ligament reconstruction with A1 pulleys and soft tissue plasty at the central cleft can significantly improve the appearance and function of the hand in type Ⅰ and type ⅡA congenital cleft hands.