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长期随访中桡侧多指（趾）畸形手手术后的复发率。

Recurrence rate after radial club hand surgery in long term follow up.

作者信息

Shariatzadeh Hooman, Jafari Dawood, Taheri Hamid, Mazhar Farid Najid

机构信息

Assistant Professor of Orthopaedic Surgery, Shafa Yahyaian Hospital, Iran University of Medical Sciences, Tehran, Iran.

出版信息

J Res Med Sci. 2009 May;14(3):179-86.

PMID:21772880
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3129058/
Abstract

BACKGROUND

Radial club hand includes wide spectrum of malformations that involve radial side of forearm. Conservative treatments are recommended to the milder types and surgical interventions specially centralization for the severe forms. Recurrence after centralization is one of the challenging problems in this anomaly. In this study, we assessed the recurrence rate of centralization in radial club hand surgery in long term follow up.

METHODS

In this retrospective study, we reviewed the records and radiographies of 9 patients with radial club hand who underwent centralization to correct the deformity in the hand surgery department. Patients' age, type of the thumb anomaly, associated anomalies in other systems, involved side, type of radial club hand, hand-forearm angle preoperative, post operative and in the last follow up visit, and centralized wrists motion range in the final follow up visit were all assessed and reported.

RESULTS

Eleven cases of radial club hand in nine patients underwent centralization. Mean age at the time of the centralization was 17 (6-72) months and mean follow up was 90 (48-170) months. Preoperative hand-forearm angle was 75 (30-110) degrees, immediate postoperative angle was 25 (15-35) degrees and in the last follow up visit it was 52 (40-60) degrees. The amount of correction was 66% and loss of correction in long term was 54%.

CONCLUSION

Centralization still can be a standard procedure in treatment of patients with radial club hand with acceptable results.

摘要

背景

桡侧多指畸形包括一系列累及前臂桡侧的畸形。对于较轻类型推荐保守治疗，而对于严重类型则推荐手术干预，特别是中心化手术。中心化手术后的复发是这种畸形中具有挑战性的问题之一。在本研究中，我们在长期随访中评估了桡侧多指畸形手术中中心化手术的复发率。

方法

在这项回顾性研究中，我们回顾了9例在手部外科接受中心化手术以矫正畸形的桡侧多指畸形患者的记录和影像学资料。评估并报告了患者的年龄、拇指畸形类型、其他系统的相关畸形、受累侧、桡侧多指畸形类型、术前、术后及最后一次随访时的手-前臂角度，以及最后一次随访时中心化手腕的活动范围。

结果

9例患者中的11例桡侧多指畸形接受了中心化手术。中心化手术时的平均年龄为17（6-72）个月，平均随访时间为90（48-170）个月。术前手-前臂角度为75（30-110）度，术后即刻角度为25（15-35）度，最后一次随访时为52（40-60）度。矫正量为66%，长期矫正丢失为54%。

结论

中心化手术仍是治疗桡侧多指畸形患者的标准手术，结果可接受。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa43/3129058/653c259e0039/JRMS-14-179-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa43/3129058/7268d00e796c/JRMS-14-179-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa43/3129058/31ae3c828583/JRMS-14-179-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa43/3129058/8a2df69cb6d4/JRMS-14-179-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa43/3129058/8b22efe22d5c/JRMS-14-179-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa43/3129058/923f55a8a89d/JRMS-14-179-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa43/3129058/653c259e0039/JRMS-14-179-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa43/3129058/7268d00e796c/JRMS-14-179-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa43/3129058/31ae3c828583/JRMS-14-179-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa43/3129058/8a2df69cb6d4/JRMS-14-179-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa43/3129058/8b22efe22d5c/JRMS-14-179-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa43/3129058/923f55a8a89d/JRMS-14-179-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa43/3129058/653c259e0039/JRMS-14-179-g006.jpg

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The recurrence of deformity after surgical centralization for radial clubhand.桡侧多指畸形手术中心化治疗后畸形的复发
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