Department of Orthopaedic Surgery, Columbia University, New York, NY, USA.
J Am Acad Orthop Surg. 2012 Feb;20(2):78-85. doi: 10.5435/JAAOS-20-02-078.
Factitious disorders of the upper extremity can manifest in many different forms; therefore, it is critical to recognize warning signs in the history and examination indicating that the patient may be creating the symptoms and physical manifestations of the presenting illness. These disorders present in such predictable patterns as lymphedema, Secretan syndrome, ulcerations and wound manipulation, clenched fist, subcutaneous emphysema, pachydermodactyly, nail deformities, and self-mutilation. Management recommendations include assigning therapeutic responsibility to one person and the involvement of a multidisciplinary team. Thorough documentation is essential for the protection of both the patient and the treating physician. Treatment of patients with factitious disorders of the upper extremity requires patience and insight to avoid being manipulated into performing unnecessary surgical procedures.
上肢的人为性疾病可以表现出许多不同的形式；因此，在病史和检查中识别出可能导致患者产生现有疾病的症状和体征的警告信号至关重要。这些疾病以可预测的模式出现，如淋巴水肿、塞克唐综合征、溃疡和伤口操作、紧握拳、皮下气肿、厚皮性骨膜病、指甲畸形和自残。管理建议包括将治疗责任分配给一个人，并涉及多学科团队。彻底的记录对于保护患者和治疗医生都是必不可少的。治疗上肢人为性疾病的患者需要耐心和洞察力，以避免被操纵进行不必要的手术。
