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通过牵引矫正手部长期关节挛缩:一例报告

Correction of long term joint contractures of the hand by distraction. A case report.

作者信息

da Silva P Natividade, Barbosa R, Ferreira P, Ferreira A, Malheiro E, Silva A, Reis J, Amarante J

机构信息

Department of Plastic and Reconstructive Surgery, Oporto Medical School, São João Hospital, Oporto, Portugal.

出版信息

Br J Plast Surg. 2005 Dec;58(8):1148-51. doi: 10.1016/j.bjps.2005.04.028. Epub 2005 Jul 21.

Abstract

Joint contractures are a common complication of hand trauma. The conventional treatment consists of arthrolysis, tenolysis and occasionally arthrodesis. Frequently, this does not achieve a good result, particularly when there has been a long delay in presentation. Progressive lengthening of a joint by distraction (joint distraction) allows the release of joint contractures even in cases of failure of traditional methods. We present a case of a delayed (20 years) work related traumatic flexion deformity of the PIP joint of the left index and middle fingers. This was the result of a complete division of both flexor tendons of both fingers. The range of movements, both active and passive, was limited to 90/100 degrees in the index finger and 95/100 degrees in the middle finger. Following joint distraction using our lengthening device (Antãotrade mark, Portugal) the patient was able to achieve an active and passive range of movements of 10/100 degrees for the PIP joint of the index finger and 40/100 degrees of the middle. This clinical case shows the simplicity and application of our technique for the correction of joint contractures.

摘要

关节挛缩是手部创伤的常见并发症。传统治疗方法包括关节松解术、肌腱松解术,偶尔还会进行关节融合术。通常情况下,这种治疗效果不佳,尤其是在就诊延迟较长时。通过牵引(关节牵张)逐渐延长关节,即使在传统方法失败的情况下也能松解关节挛缩。我们报告一例因工作相关创伤导致的左示指和中指近端指间关节屈曲畸形延迟(20年)病例。这是双侧手指屈肌腱完全断裂的结果。示指的主动和被动活动范围限制在90/100度,中指为95/100度。使用我们的延长装置(葡萄牙Antão商标)进行关节牵张后,患者示指近端指间关节的主动和被动活动范围达到10/100度,中指为40/100度。该临床病例展示了我们用于矫正关节挛缩技术的简便性和实用性。

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