CAJ | 학술논문

目的探讨根据伴第4、5趾并趾的小趾多趾畸形的外观、X线片以及术中所见骨关节表现差异进行分析、分型,以确定拟切除的多趾以及足趾畸形的矫正方法的临床效果.方法 2009年1月至2014年1月共收治54例伴第4、5趾并趾的小趾多趾畸形的患儿,对其足趾外观、X线片表现以及术中所见骨关节情况进行比较分析及分型,并确定拟切除的多趾,同时分离并趾,矫正第6趾偏斜及短趾畸形.结果根据骨关节分型,本组17侧足第5趾为肉赘型,48侧足第5趾为骨关节连接型,虽有骨关节与第6趾相连,但与近端骨关节对位对线差,故本组病例均确定第5趾为需切除的多趾.术后随访1个月至4年,保留的第6趾偏斜畸形完全矫正,短趾畸形得以改善.结论根据伴第4、5趾并趾的小趾多趾畸形的外观与骨关节表现情况进行分析、分型,并由此制定拟切除的多趾(通常是第5趾)和不同的足趾畸形矫正方案,既可以恢复正常的骨关节,又能改善足趾外形.
목적 탐토근거반제4、5지병지적소지다지기형적외관、X선편이급술중소견골관절표현차이진행분석、분형,이학정의절제적다지이급족지기형적교정방법적림상효과.방법 2009년1월지2014년1월공수치54례반제4、5지병지적소지다지기형적환인,대기족지외관、X선편표현이급술중소견골관절정황진행비교분석급분형,병학정의절제적다지,동시분리병지,교정제6지편사급단지기형.결과 근거골관절분형,본조17측족제5지위육췌형,48측족제5지위골관절련접형,수유골관절여제6지상련,단여근단골관절대위대선차,고본조병례균학정제5지위수절제적다지.술후수방1개월지4년,보류적제6지편사기형완전교정,단지기형득이개선.결론 근거반제4、5지병지적소지다지기형적외관여골관절표현정황진행분석、분형,병유차제정의절제적다지(통상시제5지)화불동적족지기형교정방안,기가이회복정상적골관절,우능개선족지외형.
Objective To investigate difference between the appearance and the bony structure in the polysyndactyly of the fifth toe fused with the fourth toe.Methods From Jan.2009 to Jan.2014,54 patients (65 feet) with polysyndactyly of the fifth toe fused with the fourth toe were treated.The appearance,X-ray and intraoperative finding were recorded and compared to classify the deformity.Then the extra toe was excised and syndactyly was separated.The malalignment and brachydactyly of the sixth toes were corrected simultaneously.Results According to the bone and joint type,the fifth toes were neoplastic toes without joints in 17 feet,or had poor bony and joint alignment with the sixth toes in 48 feet.So the fifth toes were excised in all the cases.The patients were followed up for 1 month to 4 years.The oblique deformity of sixth toes were corrected completely with improved length.Conclusions The polysyndactyly of the fifth toe fused with the fourth toe should be classified to design the excised toe(usually fifth toe) and correction procedure.The appearance and bony joint recovery are both important.