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目的探讨先天性风吹手畸形的治疗方法。方法对27例先天性风吹手畸形的患者采用分次手术的方法,一期改善拇指功能,作拇收肌切断、第一指蹼开大、拇指外展功能重建术;二期作中、小指指浅屈肌腱移位,纠正手指尺偏畸形;三期手术解决手掌、指屈曲、掌侧皮肤缺损。每次手术间隔3～6个月,期间配合系统的康复治疗。结果术后随访时间为6～72个月,5例失访。22例中有17例拇指外展、对掌、对指功能恢复,效果满意;12例手指尺偏畸形得到矫正,6例部分矫正,4例复发,其中7例再次行紧缩尺侧关节囊、调整肌张力手术,术后应用外展支具,系统康复训练后5例畸形矫正,2例部分矫正。术后8例再发手掌、指皮肤挛缩,再次行植皮术。3例发生不全并指,经指蹼成形后纠正。结论对复杂先天性风吹手畸形的治疗应分次手术为佳,每次解决一个主要问题,配合系统的康复治疗才能获得较满意的效果。
Objective To explore the treatment of congenital wind blower deformity. Methods Twenty-seven cases of congenital wind-blown hand deformity were treated by graded operation. The first stage was to improve the function of the thumb and cut the thumb of the thumb, Superficial flexor tendon shift, correct finger ruler deformity; three surgical solution of the palm, refers to the flexion, palm side of the skin defect. Each operation interval of 3 to 6 months, during the rehabilitation system with the system. Results The follow-up time was 6 to 72 months and 5 patients were lost. Of the 22 cases, 17 cases showed thumb abduction, palmar, and finger function recovery, satisfactory results were obtained. Twelve fingers were corrected for malformations, partial correction was performed in 6 cases, and recurrent in 4 cases. Seven of them were re-compressed in the ulnar joint capsule, Adjustment of muscle tension surgery, postoperative application of outreach brace, system rehabilitation training after 5 cases of deformity correction, 2 cases of partial correction. Eight cases of recurrence of the palm, referring to the skin contracture, again line of skin grafting. 3 cases of incomplete and refers to the formation after correction refers to the formation of webbed. Conclusion The treatment of complex congenital wind blow malformations should be divided surgery is better, each time to solve a major problem, with the system of rehabilitation in order to obtain more satisfactory results.