半关节移植治疗重复拇指畸形伴指间关节严重发育不良

Treatment of interphalangeal joint dysplasia in thumb duplication deformity by semi-joint transfer

目的通过半关节移植修复缺如的指间关节近端关节面及侧副韧带,重建重复拇指畸形患者严重偏斜的指间关节。方法1994年3月—2002年11月间,对7例患者利用赘生拇指近节指骨的近端关节面及部分关节囊,行一期或二期半关节移植,重建保留拇指的指间关节近端发育不良或缺如的关节面。术后随访3年,观察骨关节生长及功能恢复情况。结果移植的半关节大部存活,85%患者的骨外形良好、功能恢复较满意。结论半关节移植是治疗重复拇指畸形伴指间关节严重发育不良的一种可行的手术方法。

Objective To reconstruct the absent proximal articular surface and collateral ligaments of the interphalangeal （IP） joint and correct deviation deformity of the joint in thumb duplication by semi-joint transfer. Methods From March 1994 to November 2002, 7 eases of thumb duplication deformity were treated, The semi-joint from the excised duplicate thumb including the proximal joint surface and the joint capsule was transferred to the saved thumb either at first stage or at a second stage to reconstruct the dystrophied or missing proximal joint surface of the IP joint, All eases were followed-up for 3 years for evaluation of growth and functional restoration of the joint. Results Most of the articulation were viable. 85 % of the eases achieved good contour and satisfactory function of the joint. Conclusion Semi-joint transfer from the duplicate thumb is an effective procedure to treat interphalangeal joint dysplasia in thumb duplication deformity.