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目的总结34例38指小儿复拇指畸形的治疗体会。方法按照王澍寰临床分类法选择相应的手术方式。对于漂浮型拇指剔除漂浮指后,修整皮瓣,覆盖创面。对于远节指骨型,近节指骨型及掌骨型复拇指畸形,通过设计合理皮瓣、截骨、复位,克氏针固定及重建肌腱的附着点,术后指导功能锻炼。结果术后通过畸形拇指手术前后X线平片的对比、存留拇指的外形和发育情况,并对拇指功能进行随访。34例均得到随访6个月至5年,平均4年,拇指外形满意,骨轴线正常,功能良好,发育基本正常。结论术前应全面评估复拇指畸形,制订手术方案,可减少后期继发畸形的发生。
Objective To summarize the experience of treatment of complex thumb deformities in 34 cases of 38 children. Methods According to Wang Shuhuan clinical classification to select the appropriate surgical approach. For the floating thumb after removing the floating finger, trim the flap, covering the wound. For distal phalangeal phalanges, phalangeal phalanges and metacarpal phalanges, it is necessary to design a proper flap, osteotomy, reduction, Kirschner wire fixation and reconstruction of tendon attachment points, postoperative functional training. Results The shape and development of the thumb survived by the comparison of X - ray films before and after the operation of deformed thumbs. The thumb function was followed up. All the 34 cases were followed up for 6 months to 5 years with an average of 4 years. The thumb shape was satisfactory, the bone axis was normal, the function was good, and the development was basically normal. Conclusion Preoperative thumb should be comprehensive assessment of thumb deformity, the development of surgical options, can reduce the incidence of secondary deformity.