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[屈曲指:分类与治疗结果。基于50例病例分析]

[Camptodactyly: classification and therapeutic results. Apropos of a series of 50 cases].

作者信息

Goffin D, Lenoble E, Marin-Braun F, Foucher G

机构信息

SOS Main Strasbourg.

出版信息

Ann Chir Main Memb Super. 1994;13(1):20-5. doi: 10.1016/s0753-9053(05)80353-9.

Abstract

Fifty patients with camptodactyly of one or several fingers were seen in the Strasbourg SOS Main unit between 1980 and 1988. Classification of these lesions was based on the mobile or fixed nature of the deformity in flexion of the interphalangeal joint. This classification is useful for the therapeutic management. Treatment by dynamic splint for a mean duration of 20 months gives good results in fixed or mobile camptodactylies of small children, provided that this treatment is commenced as soon possible. This splint treatment also obtains favorable results in patients reaching the end of the growth period, whether their camptodactyly is mobile or even, in some cases, fixed. In every case, treatment by dynamic splint constitutes a therapeutic test (safety of the apparatus, patient's cooperation) and only forms of camptodactyly resistant to conservative treatments benefit from Malek's type of surgical correction. It must be remembered that a certain number of cases of camptodactyly have a potential for severity with time, progressing towards irreducible forms which can only be corrected by surgical treatment. Camptodactyly in adults must be analysed meticulously and only major deformities causing functional discomfort or major aesthetic prejudice should be operated.

摘要

1980年至1988年间,斯特拉斯堡SOS手部中心共接诊了50例单指或多指屈曲挛缩畸形患者。这些病变的分类基于指间关节屈曲畸形的可动性或固定性。这种分类对治疗管理很有用。对于小儿固定性或可动性屈曲挛缩畸形,采用动力夹板治疗平均20个月可取得良好效果,前提是尽早开始治疗。这种夹板治疗对于接近生长末期的患者也能取得良好效果,无论其屈曲挛缩畸形是可动的,甚至在某些情况下是固定的。在任何情况下,动力夹板治疗都是一种治疗性试验(器械安全性、患者配合度),只有对保守治疗有抵抗性的屈曲挛缩畸形形式才适合采用马利克式手术矫正。必须记住,一定数量的屈曲挛缩畸形病例随着时间推移有加重的可能,会发展为不可复位的形式,只能通过手术治疗矫正。对于成人屈曲挛缩畸形必须进行细致分析,只有导致功能不适或严重美学缺陷的严重畸形才应进行手术。

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