外科手术治疗风吹手畸形

目的应用外科手术方法治疗风吹手畸形。方法对26例风吹手患者采用外科手术方法治疗，一期手术应对拇指的屈曲及内收畸形，使用Z字成形或皮瓣移植的方法开放指蹼，切断拇收肌，重建拇指外展功能。二期手术解决2—5指在掌指关节处的尺偏畸形，使用中小指的指浅屈肌腱移位方法；三期手术治疗解决手掌及手指屈曲的问题，以及屈曲纠正后造成的手掌侧皮肤软组织缺损。结果术后随访6～48月。26例患者中有15例拇指指蹼开大效果满意，外展及对掌功能恢复比较满意；12例患者2—5指的尺偏畸形得到良好的纠正；7例术后效果不满意；术后手掌及手指挛缩屈曲者有5例。结论分期手术治疗以及系统的术后康复治疗才会获得良好的效果。

The surgical treatment of windblown hand deformity

Objective To reasearch the surgical treatment of the windblown hand deformity. Methods The 26 patients of windblown hand deformities were treating with surgical operations. First stage to change the thumb flexion and adduction deformity by opened the web with the method of Z angioplasty or flap transplantation, at the same time divised adductor policis muscle to rebuild the thumb exhibition function. Second stage operations were directed to transfer the flexor digitorum superficialis from the middle and little finger to correct radial deviation deformity of the metacarpophalangeal joint. Third stage operation were used to correct the flexion of the palm and fingers and soft tissue defect after that. 3- 6 months between each stages. Results Postoperatively the patients were followed--up for 6 to 48 months. In the 26 patients with long- term follow-up,15 patients had got the satisfacting web opening and recovered abduction and opposition function of the thumb. Ulnar deviation of the digits was completely corrected in 12 patients and not in 7 patients. Recurrence of the contracture of the fingers and palm was seen in 5 patients. Conclusion Multi-stages surgical treatment and postoperative rehabilitation are esseutial to good results.