先天性伸肌腱中央滑脱症的自愈

IF 1.4 3区 医学 Q3 ORTHOPEDICS
Journal of Pediatric Orthopaedics Pub Date : 2024-10-01 Epub Date: 2024-07-11 DOI:10.1097/BPO.0000000000002764
Francisco Soldado, Trong-Quynh Nguyen, Juliana Rojas-Neira, Daniel Rodriguez-Ostuni, Abdelmounim Cherqaoui, Paula Díaz-Gallardo
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引用次数: 0

摘要

背景:先天性伸指肌腱中央滑脱症是一种相对罕见的疾病,仅在2个临床系列中报告了几例儿童患者。在本研究中,我们旨在介绍大量未经治疗的此类畸形患者的自然病史:方法:本研究已获得机构审查委员会的批准,家长已按照《赫尔辛基宣言》中涉及人类的生物医学研究指南提供了知情同意书。1名外科医生对2008年6月至2021年7月期间患有这种畸形的儿童进行了回顾性分析。纳入标准包括自出生以来就存在柔软性PIP屈曲畸形的儿童,其特点是MP过伸和PIP伸展滞后。PIP完全被动伸展和没有外侧皮肤蹼可将这种情况与凸足畸形区分开来:24名患儿的57个受累手指在确诊时的平均年龄为7个月(1至17个月),平均随访时间为6年至9个月(2年至1个月至13年)。六名患者之前被误诊为外翻畸形。在最后的随访中,除4例患者有10°的残余伸展外,其余患者的PIP均完全伸展。PIP完全主动伸展的平均时间为2年至7个月(20个月至3年至9个月)。15例患儿(62.5%)的畸形为双侧,15例患儿(62.5%)的畸形仅累及1个手指(单侧或双侧),6例患儿(25%)的畸形累及2个手指。小指和无名指最常受累。7例患者有手指畸形的家族史:结论:先天性伸指肌腱中央滑脱功能不全通常会在出生后 4 年内自行缓解。文献表明,夹板治疗可以加快畸形的矫正,因此,如果可能,可以使用夹板治疗。在大多数情况下,可能会出现残余的、临床上不明显的 FDS挛缩。这种情况经常被误诊为凸足畸形:证据等级:IV。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Spontaneous Resolution of Congenital Insufficiency of the Extensor Tendon Central Slip.

Background: The congenital insufficiency of the extensor tendon central slip of the fingers is a relatively rare condition, with only a few reported cases in pediatric patients, as described in 2 clinical series. In this study, we aimed to present the natural history of a significant number of untreated patients with this deformity.

Methods: This study has received institutional review board approval, and parents provided informed consent following the Declaration of Helsinki guidelines for biomedical research involving humans. A retrospective analysis of children with this deformity, ranging from June 2008 to July 2021, was collected by 1 surgeon. The inclusion criteria included children with a supple PIP flexion deformity, characterized by MP hyperextension and PIP extension lag, which had been present since birth. Complete passive PIP extension and the absence of volar skin webbing differentiated this condition from camptodactyly.

Results: The mean age of 24 children with 57 involved digits at diagnosis was 7 months (range, 1 to 17) and the mean follow-up was 6 years to 9 months (2 yr to 1 mo to 13 yr). Six patients had an incorrect previous diagnosis of camptodactyly.Active PIP extension recovered progressively. At the final follow-up, complete PIP extension occurred in all except 4 cases in which a residual 10° extension lag. The mean time for a complete active PIP extension was 2 years to 7 months (20 mo to 3 yr to 9 mo). Nineteen cases (79%) showed a mild FDS contracture of the involved digits at the final follow-up.The deformity was bilateral in 15 children (62.5%) and involved only 1 finger (unilaterally or bilaterally) in 15 cases (62.5%), and 2 fingers in 6 (25%). Little and ring fingers were most commonly involved. In 7 cases, there was a family history of finger deformity.

Conclusions: Congenital insufficiency of the extensor tendon central slip typically resolves spontaneously within the first 4 years of life. Literature suggests that splinting can expedite the correction of the deformity and thus, if possible, it can be used. In most cases, a residual, clinically insignificant FDS contracture may be present. This condition is often misdiagnosed as camptodactyly.

Level of evidence: IV.

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来源期刊
CiteScore
3.30
自引率
17.60%
发文量
512
审稿时长
6 months
期刊介绍: ​Journal of Pediatric Orthopaedics is a leading journal that focuses specifically on traumatic injuries to give you hands-on on coverage of a fast-growing field. You''ll get articles that cover everything from the nature of injury to the effects of new drug therapies; everything from recommendations for more effective surgical approaches to the latest laboratory findings.
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