Ilizarov牵张成形技术矫正中重度虎口挛缩
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联勤保障部队第九二〇医院骨科

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云南省创伤骨科临床医学中心


Ilizarov stretch forming technique to correct moderate to severe thumb web contracture
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1.920th Hospital of Joint Logistics Support Force;2.Department of Orthopaedics, 920th Hospital of Joint Logistics Support Force, Kunming Yunnan

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Foundation Supported by Yunnan Traumatology and Orthopaedics Clinical Medical Center

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    摘要:

    [目的] 介绍Ilizarov牵张成形技术矫正中重度虎口挛缩的手术技术和初步临床结果。 [方法] 2016年2月-2019年12月,收治的7例外伤后中重度虎口挛缩患者,其中男4例,女3例;年龄22岁~50岁,平均34.429岁。所有患者均采用在第1、2掌骨头及基底上斜45°避开肌腱各穿2枚2.5mm的螺纹针,安装简易外固定撑开器,应用ilizarov牵拉成组织原理、术后逐渐撑开虎口,满意后继续外固定支架维持虎口撑开状态3周 ,随后取出外固定,应用虎口开大支具夜间维持至6周防止虎口挛缩。 [结果] 所有患者术后均获得随访,随访时间8-20个月(平均14.714个月)。7例患者经治疗后均达到临床撑开,治疗过程中患者疼痛不明显,依从性好。虎口均得到良好的撑开,无皮肤牵拉并发症发生 [结论] ilizarov牵张成形术在缓慢撑开虎口过程中可促进虎口挛缩组织快速生长,瘢痕软化,在中重度虎口挛缩中具有明显的优越性,手术操作简单,是一种新方法。

    Abstract:

    [Objective] Introduce the surgical technique and preliminary clinical results of the Ilizarov stretch forming technique to correct moderate to severe thumb web contracture. [Method] From February 2016 to December 2019, 7 cases of post-injury patients with moderate to severe thumb web contracture were treated, including 4 males and 3 females, who were 22 to 50 years old, with an average of 31 years old. All patients were treated by using two 2.5mm threaded needles on the first and second metacarpal heads and base at an oblique angle of 45° to avoid tendons and installing a simple external fixation spreader. Then, the thumb web was stretched gradually after the Ilizarov stretch forming operation. When satisfied, keep stretching the thumb web for 3 weeks with external fixation and then the external fixation was removed. A fter that, the thumb web open brace was used to maintain it at night for 6 weeks to prevent the thumb web contracture. [Results] All patients were followed up after surgery for 8-20 months (average 13 months). All 7 patients reached clinical distraction after treatment. During the treatment, the patients had good compliance without obvious pain.Meanwhile, the thumb web was well stretched without skin traction complications. [Conclusion] The Ilizarov stretch forming technique can promote the rapid growth of the thumb web tissue and soften the scar during the slow expansion of the thumb web. It has obvious advantages in moderate to severe thumb web contracture. The operation is simple and it is a new method.

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  • 收稿日期:2020-11-24
  • 最后修改日期:2021-03-21
  • 录用日期:2021-04-26
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