先天性中央腱发育不良的手术疗效
Surgical treatment of congenital central slip hypoplasia
刘宇洲 1徐秀玥 1王乐 2劳杰 1庄永青 3方有生1
作者信息
- 1. 复旦大学附属华山医院手外科,上海 200040;卫健委手功能重建重点实验室,上海 200032;上海市周围神经显微外科重点实验室,上海 200032;上海市手外科研究所,上海 200040;复旦大学手外科研究所,上海 200040
- 2. 上海交通大学医学院附属瑞金医院儿外科,上海 200020
- 3. 深圳市人民医院手显微外科,深圳 518020
- 折叠
摘要
目的 评估先天性中央腱发育不良手术治疗效果.方法 我们对8例(16指)先天性中央腱发育不良患者进行了长期随访,随访时间均大于3年.患指根据中央腱止点至近指间关节的距离,分别进行了中央腱前移或掌长肌腱移植修复术.术后随访的评价方法包括患指近指间关节伸直角度、抓握功能及并发症.结果 16指中,8指为Ⅰ型,采用中央腱前移术;8指为Ⅱ型,采用肌腱移植修复中央腱.术前近指间关节的平均伸直角度为-91°(-80°～-100°).随访时间为3.2～5.8年,平均4.6年,术后近指间关节的平均伸直角度为-19°(0°～-45°).术后所有患指近指间关节伸直角度均较术前明显改善(P＜0.05).Ⅰ型和Ⅱ型近指间关节伸直角度的改善差异无统计学意义(P=0.918).所有患手的抓握功能均较术前改善.结论 先天性中央腱发育不良采用中央腱前移或肌腱移植手术治疗,经过长期随访证实两种手术方式均可达到有效的功能恢复.
Abstract
Objective To evaluate the efficacy of the surgical treatment for congenital central slip hypoplasia.Methods We conducted a long-term follow-up on 8 patients(16 fingers)with congenital central slip hypoplasia for a period of more than 3 years.The affected finger underwent tendon advancement or tendon graft based on the distance from the insertion point of the central slip to the interphalangeal joint.The evaluation methods for postoperative follow-up include the angle of extension of the proximal interphalangeal joint of the affected finger,grip function,and complications.Results Among the 16 fingers,8 were of type Ⅰ and underwent tendon advancement,and 8 were of type Ⅱ and underwent tendon graft to repair the central slip.The average preoperative extension angle of the interphalangeal joint was -91°(-80° to -100°).The follow-up period was 3.2 to 5.8 years,with an average of 4.6 years.The average postoperative extension angle of the interphalangeal joint was-19°(0° to -45°).The extension angle of the interphalangeal joint of all affected fingers improved significantly after surgery compared to before surgery(P＜0.05).There was no statistically significant difference in the improvement of proximal interphalangeal joint extension angle between type Ⅰ and type Ⅱ(P=0.918).The grip function of all affected hands improved compared to before surgery.Conclusion The congenital central slip hypoplasia can be treated surgically with tendon advancement or tendon graft.The long-term follow-up had confirmed that both surgical methods could achieve effective functional recovery.
关键词
手畸形,先天性/治疗结果/中央腱/肌腱前移/肌腱移植Key words
Hand deformities,congenital/Treatment outcome/Central slip/Tendon advancement/Tendon graft引用本文复制引用
基金项目
国家自然科学基金面上项目(81972122)
上海市重点临床专科建设项目(shslczdzk05601)
上海市周围神经显微外科重点实验室项目(20DZ2270200)
深圳市三名工程项目(SZSM202111015)
出版年
2024
NETL
NSTL
万方数据