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[手指创伤后鹅颈畸形的治疗。关于43例患者的系列研究]

[Treatment of post-traumatic swan-neck deformities of the fingers. Apropos of a series of 43 patients].

作者信息

Foucher G, Tilquin B, Lenoble E

机构信息

SOS main Strasbourg.

出版信息

Rev Chir Orthop Reparatrice Appar Mot. 1992;78(8):505-11.

PMID:1340929
Abstract

Thirty three patients with 51 swan neck deformities were reviewed with a mean follow up of 35 months (6 to 86 months). 8 fingers presenting some stiffness necessitated a first step of splinting before operation giving nevertheless 5 excellent and good results. Among the other fingers with full range of passive motion surgery was performed in 38 cases with 81.5 per cent of excellent and good results. According to etiology, articular or extrinsic, excellent and good results were respectively 71 per cent and 94 per cent. The most frequently used operations were Littler type II (12 cases) and Littler type III (S.O.R.L. 11 cases) giving respectively 75 per cent and 82 per cent of excellent and good results, despite frequent minor complications. Tenodesis with translocation of a lateral extensor band gave in half the cases some extension lack at DIPJ (less than 20 degrees in 62.5 per cent). Finally direct surgery of mallet finger complicated by a swan-neck deformity led constantly to good correlation at the PIP level.

摘要

对33例患有51处鹅颈畸形的患者进行了回顾性研究,平均随访35个月(6至86个月)。8根出现一定程度僵硬的手指在手术前需要先进行夹板固定,最终有5例获得了优良效果。在其他被动活动范围正常的手指中,38例接受了手术,优良率为81.5%。根据病因,关节性或外在性病因导致的畸形,优良率分别为71%和94%。最常用的手术是Littler II型(12例)和Littler III型(S.O.R.L. 11例),尽管经常出现轻微并发症,但优良率分别为75%和82%。外侧伸肌腱束移位的腱固定术在一半的病例中导致远侧指间关节(DIPJ)出现一定程度的伸展受限(62.5%的病例小于20度)。最后,槌状指并发鹅颈畸形的直接手术在近端指间关节(PIP)水平始终产生良好的相关性。

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