Tsuyuguchi Y, Masada K, Kawabata H, Kawai H, Ono K
J Hand Surg Am. 1985 Sep;10(5):613-8. doi: 10.1016/s0363-5023(85)80193-3.
Over a 10-year period, 43 patients (75 hands) with congenital clasped thumb were seen in our institution. Three groups were identified: group I, 14 patients (24 hands) without contracture; group II, 14 patients (21 hands) with contractures of the palmar side; and group III, 15 patients (30 hands) with arthrogryposis multiplex congenita. Forty-two hands were treated with splinting alone and 16 hands with surgery. The remaining 17 hands were followed conservatively without splinting or surgery. The mean follow-up was 32 months. The results were evaluated by active abduction of the carpometacarpal joint and extension of metacarpophalangeal joint. All patients in group I showed good response to splinting, and the cause of the deformity appeared to be the predominance of the flexor muscles. In groups II and III, 10 patients (16 hands) who had severe deformity or no response to splinting were treated by release of the palmar soft tissues, skin grafts, and reconstruction of the extensors. Satisfactory results were obtained in 12 of 16 hands.
在10年期间，我们机构共诊治了43例（75只手）先天性拇指内收畸形患者。分为三组：第一组，14例患者（24只手）无挛缩；第二组，14例患者（21只手）有掌侧挛缩；第三组，15例患者（30只手）患有先天性多发性关节挛缩症。42只手仅接受了夹板治疗，16只手接受了手术治疗。其余17只手采用保守治疗，未进行夹板固定或手术。平均随访时间为32个月。通过腕掌关节主动外展和掌指关节伸展来评估结果。第一组所有患者对夹板治疗反应良好，畸形原因似乎是屈肌占优势。在第二组和第三组中，10例（16只手）有严重畸形或对夹板治疗无反应的患者接受了掌侧软组织松解、植皮和伸肌重建治疗。16只手中有12只取得了满意的结果。
