Benson L S, Waters P M, Kamil N I, Simmons B P, Upton J
Department of Orthopaedic Surgery, Northwestern University Medical School, Evanston Hospital, Illinois 60201.
J Pediatr Orthop. 1994 Nov-Dec;14(6):814-9.
To assess the relationship between clinical presentation and response to treatment, we reviewed the management of 59 involved proximal interphalangeal (PIP) joints in 22 patients with camptodactyly at a mean follow-up of 33 months. This population represented 24 cases of isolated infantile camptodactyly (type I), five cases of adolescent camptodactyly (type II), and 30 cases of syndromic camptodactyly (type III). Treatment response was assessed through passive range of motion measurements. Splinting and close adherence to an occupational therapy program were particularly effective for type I digits. We also recommend this approach for type II and type III camptodactyly, although severe deformities and well-established contractures are more common in these patients. We reserve operative intervention for only those patients who fail nonoperative management.
为评估临床表现与治疗反应之间的关系,我们回顾了22例先天性屈曲挛缩指患者59个受累近端指间(PIP)关节的治疗情况,平均随访33个月。该人群包括24例孤立性婴儿先天性屈曲挛缩指(I型)、5例青少年先天性屈曲挛缩指(II型)和30例综合征性先天性屈曲挛缩指(III型)。通过被动活动度测量评估治疗反应。夹板固定并严格遵循职业治疗方案对I型手指特别有效。对于II型和III型先天性屈曲挛缩指,我们也推荐这种方法,尽管这些患者中严重畸形和已形成的挛缩更为常见。我们仅对非手术治疗失败的患者保留手术干预。