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目的探讨先天性复合性并指畸形的临床特点、治疗方法及效果。方法总结近10年先天性复合性并指畸形47例,其中短指并指19例,短指交叉并指7例,多指并指6例,Poland综合征4例,铲状手2例,Apert综合征2例,缺指并指2例,分裂手多指并指1例,其他类型4例。一次手术完成分指21例,一次以上手术完成分指26例,同时对部分伴发畸形进行手术治疗。结果术后随访时间平均16个月,患者家长对术后手功能总的主观满意率为83%(39/47),对手部外形总的主观满意率为60%(28/47)。实施分指的234个手指中,有34个手指术后残留瘢痕挛缩、指蹼瘢痕粘连或侧偏畸形,需进一步手术治疗。结论复合性并指畸形病理表现复杂,畸形以多手指受累、多种手畸形混合、外形及功能损害严重为主要临床特点,手术分指可以获得满意的功能改善,对外形的改善有待改进。
Objective To investigate the clinical features, treatment methods and effects of congenital complex deformities. Methods A total of 47 cases of congenital complex and deformity were summarized in the past 10 years. Among them, 19 cases were short fingers and fingers, 7 cases were short fingers and 6 cases were fingers and fingers, 4 cases were Poland syndrome, 2 cases were spatula, Apert syndrome in 2 cases, lack of finger and finger in 2 cases, multi-finger split refers to 1 case and other types of 4 cases. A surgical completion of the sub-indexing in 21 cases, more than one operation to complete the sub-refers to 26 cases, at the same time on some of the associated malformations for surgical treatment. Results The average follow-up time was 16 months. The total subjective satisfactory rate of hand function was 83% (39/47) and the subjective satisfaction rate of hand shape was 60% (28/47). Of the 234 fingers involved in the indexing procedure, there were 34 residual scar contracts after finger operation, which means that the webbed scar adhesions or deformity deformities require further surgical treatment. Conclusions The complex and deformity pathological manifestations are complex. Deformity involves multiple finger involvement, multiple hand deformities, and severe shape and functional impairment as the main clinical features. Satisfactory functional improvement can be obtained through surgical fingering, and the improvement of the shape needs to be improved.