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《中国美容医学》[ISSN:1008-6445/CN:61-1347/R]

卷:

期数:

2021年9期

页码:

58-62

栏目:

出版日期:

2021-09-10

文章信息/Info

Title:

 Comparison of Axial Correction of Nail Border Plasty and Bilhaut-Cloquet Fusion in
the Treatment of Wassel Type Ⅰ and Ⅱ of Polydactyly

文章编号:

1008-6455（2021）09-0058-05

作者:

 曾冬莲; 刘 俊

Author(s):

 ZENG Dong-lian; LIU Jun

关键词:

 [关键词]轴向矫正甲缘成形术; Bilhaut-Cloquet融合术; 多指畸形; WasselⅠ、Ⅱ型; 美观度; 应激反应

Keywords:

 Key words: axial correction of nail border plasty;  Bilhaut-Cloquet fusion;  polydactyly;  Wassel type Ⅰ and Ⅱ;  degree ofaesthetic;  stress response

分类号:

R682.1+5

文献标志码:

A

摘要:

[摘要]目的：探讨轴向矫正甲缘成形术与Bilhaut-Cloquet融合术治疗多指畸形WasselⅠ、Ⅱ型对美观度、关节功能的影
响。方法：选取2017年1月-2018年12月笔者医院收治的82例多指畸形WasselⅠ、Ⅱ型患儿，分为两组，各41例。观察组采用
轴向矫正甲缘成形术，对照组采用Bilhaut-Cloquet融合术。比较两组手术效果、手术一般情况（手术时间、术中出血量、
住院时间、术后伤口愈合时间）、解剖学参数（患侧指甲宽度与健侧差值、指间关节主动屈曲、指间关节主动伸直受限、
掌指关节主动屈曲、掌指关节主动伸直受限）、应激反应[C反应蛋白（C-reactive protein，CRP）、皮质醇（Cortisol，
Cor）、丙二醛（Malondialdehyde，MDA）、总超氧化物歧化酶(Total superoxide dismutase，T-SOD)]、美观度及并发症
情况。结果：术后1.5年观察组关节活动度、尺偏或桡偏角度分布优于对照组，关节功能优患儿占比高于对照组，差异有统
计学意义（P ＜0.05）。观察组术中出血量低于对照组，差异有统计学意义（P ＜0.05）。术后1.5年观察组患侧指甲宽度与
健侧差值低于对照组，指间关节主动屈曲、掌指关节主动屈曲高于对照组，差异有统计学意义（P ＜0.05）。观察组术后
1d、3d CRP、Cor、MDA低于对照组，T-SOD高于对照组，差异有统计学意义（P ＜0.05）。术后1.5年观察组甲体外形、表面
粗糙程度、甲宽度患侧与健侧的比值、主观满意度优于对照组，差异有统计学意义（P ＜0.05）。观察组瘢痕挛缩率低于对
照组，差异有统计学意义（P ＜0.05）。结论：与Bilhaut-Cloquet融合术相比，轴向矫正甲缘成形术能有效提高多指畸形
WasselⅠ、Ⅱ型患儿关节功能恢复效果，减少术中出血量，改善解剖学参数，减轻应激反应，提高美观度，降低并发症发生
风险。

Abstract:

Abstract: Objective To investigate the effect of axial correction of nail border plasty and Bilhaut-Cloquet fusion in the
treatment of Wassel type Ⅰ and Ⅱ of polydactyly on the degree of aesthetic and joint function. Methods From January
2017 to December 2018, 82 children with Wassel type Ⅰ and Ⅱ of polydactyly were selected from our hospital and divided
into two groups, with 41 cases in each group. The observation group was treated with axial correction of nail border plasty,
while the control group was treated with Bilhaut-Cloquet fusion. The surgical effects and general conditions (operation time,
intraoperative blood loss, hospital stay, postoperative wound healing time), anatomical parameters (the difference between
the width of the affected side nail and the healthy side, limited active flexion of the interphalangeal joint and active extension
of the interphalangeal joint, limited active flexion of metacarpophalangeal joint and active extension of metacarpophalangeal
joint), stress response [C-reactive protein (CRP), cortisol (Cor), malondialdehyde (MDA), total superoxide dismutase (T-SOD)],
degree of aesthetic, and complications were compared between the two groups. Results The distribution of joint range of
motion, ulnar deviation or radial deviation angle in the observation group was better than the control group at 1.5 years after
operation, and the proportion of children with excellent joint function was higher than that in the control group, the differences
were statistically significant (P ＜0.05). The intraoperative blood loss in the observation group was lower than that in the control
group (P ＜0.05). 1.5 years after the operation, the difference between the width of the affected side and the healthy side of the
observation group was lower than that of the control group, and the active flexion of the interphalangeal joint and the active
flexion of the metacarpophalangeal joint were higher than those of the control group (P ＜0.05). CRP, Cor and MDA in the
observation group were lower than those in the control group at 1 and 3 days after operation, and T-SOD was higher than in
the control group (P ＜0.05). 1.5 years after operation, the appearance of the nail, the degree of surface roughness, the ratio of
nail width between the affected side to the healthy side, and the degree of subjective satisfaction of the observation group were
better than those of the control group (P ＜0.05). The contracture rate of scar in the observation group was lower than that in
the control group (P ＜0.05). Conclusion Compared with Bilhaut-Cloquet fusion, axial correction of nail border plasty can
effectively improve the recovery of joint function in children with Wassel type Ⅰ and Ⅱ of polydactyly, reduce intraoperative
blood loss, improve anatomical parameters, reduce stress response, improve the degree of aesthetic, and reduce the risk of
complications.

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更新日期/Last Update: 2021-10-09