手腕和手部先天性缺损患者手术后的放射学和临床结果。

Radiological and clinical outcome after operations in patients with congenital deficiencies of the wrist and hand.

机构信息

Department of Orthopedic Surgery, University of Heidelberg, Germany.

出版信息

Eur J Radiol. 2011 Feb;77(2):261-8. doi: 10.1016/j.ejrad.2010.10.023. Epub 2010 Nov 17.

DOI:10.1016/j.ejrad.2010.10.023

PMID:21087835

Abstract

PURPOSE

To evaluate the incidence, therapy results, complications and radiologic workup of operatively treated congenital disorders of the hand and wrist in a large university center during a 10-year period.

METHODS

The institutional database was retrospectively analysed for patients with congenital disorders of the hand and wrist treated operatively during a 10-year period (1998-2007). Disorders were classified according to Van Schoonhoven into 11 different entities. For each entity the incidence, the patients' age at the time of operation, the pre- and postoperative clinical and radiological workup and the frequency of complications and reoperations were evaluated.

RESULTS

A total of 278 patients was treated operatively for congenital disorders of the hand and wrist with syndactyly being present in 112, thumb hypoplasia in 15, polydactyly in 11, radial clubhand in 7, radioulnar synostosis in 6, clinodactyly in 6, thumb duplication in 6, brachydactyly in 4 and macrodactyly in 4 cases. Patients' age at the time of operation varied substantially between the different entities with a mean age between 0.9 and 6.2 years. There were 9 complications (3%, n = 278)--all of them infections. There were 28 reoperations (10%, n = 278), 13 of them (5%, n = 278) due to reoccurring webs in syndactyly.

CONCLUSION

Congenital disorders of the hand and wrist include various rare diseases with syndactyly and thumb hypoplasia being the most frequent entities. As a rule, diagnosis is obtained clinically. Radiologic workup typically consists of plain radiography. Complications are rare, whereas reoperations are frequent, mostly due to reoccurring webs in syndactyly.

摘要

目的

评估在一个大型大学中心，10 年间手术治疗先天性手部和腕部疾病的发病率、治疗结果、并发症和影像学检查结果。

方法

回顾性分析 1998 年至 2007 年间在该机构接受手术治疗的先天性手部和腕部疾病患者的数据库。根据 Van Schoonhoven 的分类方法，将疾病分为 11 种不同的类型。对于每种类型，评估其发病率、手术时患者的年龄、术前和术后的临床和影像学检查结果以及并发症和再次手术的频率。

结果

共有 278 例患者因先天性手部和腕部疾病接受手术治疗，其中并指症 112 例，拇指发育不良 15 例，多指畸形 11 例，桡侧半掌骨缺失 7 例，尺桡骨融合 6 例，指内弯畸形 6 例，拇指重复畸形 6 例，短指畸形 4 例，巨指畸形 4 例。不同类型的患者手术时的年龄差异很大，平均年龄在 0.9 至 6.2 岁之间。共有 9 例（3%，n=278）并发症，均为感染。共有 28 例再次手术（10%，n=278），其中 13 例（5%，n=278）是由于并指症的再次出现。