【摘要】 目的比较赘指切除加侧副韧带重建术和Bilhaut-Cloquet术两种术式治疗WasselⅡ型复拇指畸形的长期疗效,探讨合理的术式选择方法。方法回顾性研究了10例患儿(11指)WasselⅡ型复拇指畸形的病例,其中有3指复拇畸形采用Bilhaut-Cloquet方法治疗,8指采用赘指切除加侧副韧带重建方式进行矫治,手术时年龄为6个月～10岁。重点分析术后功能恢复和外观恢复情况。结果术后本组病例平均随访时间[(12.4±2.1)年,(?)±s,下同],两种术式都能获得比较好的拇指指间关节的稳定性;在拇指指间关节活动度方面,赘指切除加侧副韧带重建术后平均为(51.7±10.1)°,而Bilhaut- Cloquet术后平均为(11.7±9.3)°,两者差异有统计学意义。在拇、示指捏力方面两者差异无统计学意义。在患指术后末节指骨对线方面Bilhaut-Cloquet术具有一定的优势,但该术式术后均残留指甲的线状沟槽或突起。结论对于WasselⅡ型复拇指畸形宜早期采用赘指切除加侧副韧带重建术进行矫治,如果患儿年龄较大,两个末节指骨发育较均衡,可考虑采用Bilhaut-Cloquet术。更多还原

【Abstract】 Objective To compare the long-term results of duplicate thumb excision with collateral ligament reconstruction and Bilhaut-Cloquet procedure for the treatment of Wassel typeⅡthumb duplication,and provide a rational strategy for surgery selection.Methods Eleven sides out d 10 cases with thumb duplication of Wassel typeⅡwere studied retrospectively for their surgical results.Among them,3 sides were treated with Bilhaut-Cloquet procedure,while the other 8 sides received duplicate thumb excision with collateral ligament reconstruction.The long-term follow-up materials of these patients were carefully investigated.The functional status as well as the cosmetic condition was evaluated.Results The average follow-up time for these patients was 12.4±2.1 years.Both procedures achieved joint stability.As to the range of motion,the results of excision with ligament reconstruction(51.7°±10.1°)were much better than those of the Bilhaut-Cloquet procedure (11.7°±9.3°).The difference was statistically significant.There was no significant difference in pinch power. Bilhaut-Cloquet procedure showed advantages for alignment of the distal phalanx,but it also left a ruffled nail for each patient.Conclusion It is recommended to use duplicate thumb excision with collateral ligament reconstruction to treat Wassel typeⅡthumb duplication for infants.Bilhaut-Cloquet procedure can only be used for older patients.更多还原