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一项在三级护理中心对手指挛缩的前瞻性研究及其处理。

A Prospective Study of Contracture of the Finger and its Management in a Tertiary Care Center.

机构信息

Department of General Surgery, Maharaja Suhel Dev Autonomous State Medical College and Mahrishi Balark Hospitals, Bahraich, Uttar Pradesh, India.

Department of General Surgery, BRD Medical College, Gorakhpur, Uttar Pradesh, India.

出版信息

Ann Afr Med. 2024 Jul 1;23(3):482-487. doi: 10.4103/aam.aam_153_23. Epub 2024 Jul 20.

Abstract

BACKGROUND

When the range of motion between two finger segments, both active and passive, is restricted, finger contracture occurs. The aim of this study is to investigate the best procedure to eliminate finger contracture and the functional and esthetic results of the different surgical procedures.

MATERIALS AND METHODS

A total of 31 patients with soft-tissue abnormalities of the hand were included in this prospective study. They underwent either contracture removal with K-wire and skin grafts or various flap procedures in the department of plastic surgery. Complaints of stiffness and discomfort were classified into five categories: none, mild, moderate, marked, and severe. The difficulty a person had in picking up objects, grasping, writing, etc., was used to determine the degree of disability. Absenteeism from work and surgical site infections were also recorded.

RESULTS

The mean age was 20.25 years, with a mean age of 23.05 for men and 15.83 for women. Overall, most cases occurred in the age range of 3-10 years. For K-wire surgery with skin grafting, the typical time off work was 24 days. The average recovery time ranged from 15.2 days for skin grafts to 16.9 days for tenolysis, 28.33 days for groyne flaps, and 41 days for abdominal flaps. Of all cases, 12 (38.00%) had a fair result, 10 (31.04%) had a moderate result, and 9 (30.96%) had an excellent result.

CONCLUSION

The most feasible method for treating these situations, which offers the greatest potential for a functional and cosmetic result, is contracture reduction with skin grafting.

摘要

背景

当两个手指段之间的活动范围受到限制时,会发生手指挛缩。本研究旨在探讨消除手指挛缩的最佳方法,以及不同手术方法的功能和美观效果。

材料与方法

本前瞻性研究共纳入 31 例手部软组织畸形患者。他们在整形外科接受了 K 线针和皮片切除挛缩或各种皮瓣手术。将僵硬和不适的抱怨分为五个等级:无、轻度、中度、显著和严重。根据患者捡起物体、抓握、书写等的困难程度来确定残疾程度。还记录了旷工和手术部位感染的情况。

结果

平均年龄为 20.25 岁,男性平均年龄为 23.05 岁,女性为 15.83 岁。总体而言,大多数病例发生在 3-10 岁年龄组。对于 K 线针手术加皮片移植,典型的停工时间为 24 天。平均恢复时间从皮片移植的 15.2 天到松解术的 16.9 天,腹股沟皮瓣的 28.33 天,腹部皮瓣的 41 天不等。所有病例中,12 例(38.00%)结果良好,10 例(31.04%)结果中等,9 例(30.96%)结果优秀。

结论

对于这些情况,最可行的治疗方法是皮片移植的挛缩松解术,它提供了最大的功能和美容效果潜力。

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本文引用的文献

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Study on Surgical Management of Post Burn Hand Deformities.烧伤后手部畸形的外科治疗研究
J Clin Diagn Res. 2015 Aug;9(8):PC06-10. doi: 10.7860/JCDR/2015/13316.6347. Epub 2015 Aug 1.
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Postburn contractures of the hand.手部烧伤后挛缩
J Hand Surg Am. 2014 Sep;39(9):1869-76. doi: 10.1016/j.jhsa.2014.03.018.
4
Management of the stiff finger: evidence and outcomes.僵硬手指的管理:证据与结果
Clin Plast Surg. 2014 Jul;41(3):501-12. doi: 10.1016/j.cps.2014.03.011.
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Management of limited joint mobility in diabetic patients.糖尿病患者的关节活动度受限的管理。
Diabetes Metab Syndr Obes. 2013 May 7;6:197-207. doi: 10.2147/DMSO.S33943. Print 2013.
8
Management of post burn hand deformities.烧伤后手部畸形的处理
Indian J Plast Surg. 2010 Sep;43(Suppl):S72-9. doi: 10.4103/0970-0358.70727.

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