目的:探讨先天性拇指多指畸形的病因、临床表现、诊疗方法、手术时机及预后,增强对该病的认知了解,提升对该病的临床诊治能力。方法:对本院收治的3例先天性拇指多指畸形患者的病例特点进行分析,同时检索复习相关文献。结果:3例患者均为重复拇指畸形表现,影像学表现典型,2例经初次手术治疗后外形及功能均得到明显改善,1例发生瘢痕挛缩,经二次矫形术后恢复良好。结论:先天性重复拇指畸形是一种轴前型多指畸形疾病,主要与遗传因素有关;其症状典型,较易诊断,但种类繁多,解剖结构复杂,且早期易影响拇指发育,进而影响外观及功能,固选择合适的时机行外科手术为治疗重复拇指畸形的首选;术后应注意局部切口护理并尽早加强功能断练,防止切口感染、瘢痕挛缩等;重复拇指畸形的总体预后较好,但由于术后较易出现继发性畸形,应充分做好术前评估,遵循个体化治疗原则。
Objective: To investigate the etiology, clinical manifestations, diagnosis and treatment methods, surgical timing and prognosis of congenital thumb polydactyly, so as to enhance the cognitive un-derstanding of the disease and improve the clinical diagnosis and treatment ability of the disease. Methods: The characteristics of 3 cases of congenital thumb polydactyly treated in our hospital were analyzed, and the relevant literature was retrieved and reviewed. Results: All the 3 patients pre-sented with repetitive thumb deformity, and the imaging manifestations were typical. The appear-ance and function of 2 patients were significantly improved after the initial operation, and 1 case developed cicatricial contracture, which recovered well after the second correction. Conclusion: Congenital repetitive thumb malformation is a kind of preaxial polydactyly, which is mainly related to genetic factors. The symptoms are typical and easy to diagnose, but there are many kinds and complex anatomical structures. It is easy to affect the development of the thumb at an early stage, and then affect the appearance and function of the thumb. Postoperative local incision care should be paid attention to and functional failure should be strengthened as soon as possible to prevent in-cision infection and cicatricial contracture. The overall prognosis of repetitive thumb deformity is good. However, due to the high incidence of secondary deformity after operation, preoperative evaluation should be fully done and the principle of individualized treatment should be followed.
拇指多指畸形,临床表现,分型,诊断,治疗, Thumb Polydactyly Clinical Manifestations Parting Diagnosis Treatment摘要
Objective: To investigate the etiology, clinical manifestations, diagnosis and treatment methods, surgical timing and prognosis of congenital thumb polydactyly, so as to enhance the cognitive understanding of the disease and improve the clinical diagnosis and treatment ability of the disease. Methods: The characteristics of 3 cases of congenital thumb polydactyly treated in our hospital were analyzed, and the relevant literature was retrieved and reviewed. Results: All the 3 patients presented with repetitive thumb deformity, and the imaging manifestations were typical. The appearance and function of 2 patients were significantly improved after the initial operation, and 1 case developed cicatricial contracture, which recovered well after the second correction. Conclusion: Congenital repetitive thumb malformation is a kind of preaxial polydactyly, which is mainly related to genetic factors. The symptoms are typical and easy to diagnose, but there are many kinds and complex anatomical structures. It is easy to affect the development of the thumb at an early stage, and then affect the appearance and function of the thumb. Postoperative local incision care should be paid attention to and functional failure should be strengthened as soon as possible to prevent incision infection and cicatricial contracture. The overall prognosis of repetitive thumb deformity is good. However, due to the high incidence of secondary deformity after operation, preoperative evaluation should be fully done and the principle of individualized treatment should be followed.
袁婧轩,陈振雨. 先天性拇指多指畸形3例报告及文献分析Congenital Thumb Polydactyly: Report of 3 Cases and Literature Analysis[J]. 临床医学进展, 2022, 12(11): 10656-10662. https://doi.org/10.12677/ACM.2022.12111534
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