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Clinical Characteristics and Surgical Outcomes of Congenital Ulnar-deviated Thumbs
Journal of Pediatric Orthopaedics ( IF 1.4 ) Pub Date : 2020-10-20 , DOI: 10.1097/bpo.0000000000001679
Bingqiang Han , Kaiying Shen , Zhigang Wang , Yunlan Xu

Background: Delta triphalangeal thumbs (DTPT) and irregular epiphysis thumbs (IET) had different anatomic deformities. Our primary purpose was to evaluate the clinical and radiographic outcomes of surgical treatment in DTPT and IET. Methods: In total, 43 ulnar-deviated thumbs were included and categorized into 2 types according to x-ray and exploration during surgery, DTPT and IET. Surgical excision of the delta phalanx in DTPT and intraepiphysis osteotomy in IET was conducted. Results: In total, 23 ulnar-deviated thumbs were classified as DTPT and 20 as IET. Ten thumbs that could not be classified initially were followed-up until they could be categorized at the mean age of 24 months. The preoperative mean degrees of ulnar deviation at the interphalangeal joints were 40 and 33 degrees, in DTPT and IET, respectively. The mean degrees were 2 and 5 degrees in final follow-up, showing significant improvement (DTPT, P<0.05; IET, P<0.05). Complications during the study included residual ulnar deviation, overcorrection, and nonunion. The stability and range of movement at the interphalangeal joint were good overall. According to the Japanese Society for Surgery of the Hand scoring system, results were excellent in 29 cases, good in 13, and fair in 1. Conclusions: Ulnar clinodactyly of the thumb occurs because of different anatomic features such as DTPT or IET. We recommend surgical treatment be postponed until the anatomic abnormality can be ascertained. Furthermore, almost all patients with ulnar-deviated thumbs had significant improvement in clinical and radiographic outcomes after surgery.

中文翻译:

先天性尺骨偏斜的临床特征及手术结果

背景:三角拇指(DTPT)和不规则骨骺拇指(IET)有不同的解剖畸形。我们的主要目的是评估 DTPT 和 IET 手术治疗的临床和影像学结果。方法:共纳入43个尺骨偏斜的拇指,根据术中X线和探查分为DTPT和IET 2种类型。进行了 DTPT 中的 delta 指骨手术切除和 IET 中的骨骺内截骨术。结果:总共有23个尺骨偏斜的拇指被归类为DTPT,20个被归类为IET。对最初无法分类的 10 个拇指进行随访,直到它们在 24 个月的平均年龄可以分类。DTPT 和 IET 中指间关节的术前平均尺偏度分别为 40 度和 33 度。末次随访时平均度数分别为2度和5度,显示有显着改善(DTPT,P<0.05;IET,P<0.05)。研究期间的并发症包括残余尺骨偏斜、过度矫正和骨不连。指间关节的稳定性和活动范围总体良好。根据日本手外科学会评分系统,优 29 例,良 13 例,可 1 例。结论:拇指尺侧斜指的发生是由于 DTPT 或 IET 等不同的解剖特征。我们建议推迟手术治疗,直到可以确定解剖异常。此外,几乎所有拇指尺骨偏斜的患者在手术后的临床和影像学结果都有显着改善。P<0.05;IET,P<0.05)。研究期间的并发症包括残余尺骨偏斜、过度矫正和骨不连。指间关节的稳定性和活动范围总体良好。根据日本手外科学会评分系统,优 29 例,良 13 例,可 1 例。结论:拇指尺侧斜指的发生是由于 DTPT 或 IET 等不同的解剖特征。我们建议推迟手术治疗,直到可以确定解剖异常。此外,几乎所有拇指尺骨偏斜的患者在手术后的临床和影像学结果都有显着改善。P<0.05;IET,P<0.05)。研究期间的并发症包括残余尺骨偏斜、过度矫正和骨不连。指间关节的稳定性和活动范围总体良好。根据日本手外科学会评分系统,优 29 例,良 13 例,可 1 例。结论:拇指尺侧斜指的发生是由于 DTPT 或 IET 等不同的解剖特征。我们建议推迟手术治疗,直到可以确定解剖异常。此外,几乎所有拇指尺骨偏斜的患者在手术后的临床和影像学结果都有显着改善。指间关节的稳定性和活动范围总体良好。根据日本手外科学会评分系统,优 29 例,良 13 例,可 1 例。结论:拇指尺侧斜指的发生是由于 DTPT 或 IET 等不同的解剖特征。我们建议推迟手术治疗,直到可以确定解剖异常。此外,几乎所有拇指尺骨偏斜的患者在手术后的临床和影像学结果都有显着改善。指间关节的稳定性和活动范围总体良好。根据日本手外科学会评分系统,优 29 例,良 13 例,可 1 例。结论:拇指尺侧斜指的发生是由于 DTPT 或 IET 等不同的解剖特征。我们建议推迟手术治疗,直到可以确定解剖异常。此外,几乎所有拇指尺骨偏斜的患者在手术后的临床和影像学结果都有显着改善。我们建议推迟手术治疗,直到可以确定解剖异常。此外,几乎所有拇指尺骨偏斜的患者在手术后的临床和影像学结果都有显着改善。我们建议推迟手术治疗,直到可以确定解剖异常。此外,几乎所有拇指尺骨偏斜的患者在手术后的临床和影像学结果都有显着改善。
更新日期:2020-10-20
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