拇趾PIP关节移植治疗IIIB拇指发育不全的结果:当极化被拒绝时是否合理?

IF 1.9 4区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL
Michał Górecki, Piotr Czarnecki, Ewa Bręborowicz, Leszek Romanowski
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引用次数: 0

摘要

背景:截肢后食指极化是治疗III型B拇指发育不全的金标准。然而,尽管成功率很高,一些家长还是拒绝这种手术,因为它会导致有四个手指的手。目的:评估8例III型B型拇指发育不全患者的重建手术结果,这些患者在未获得父母同意的情况下,使用从足部获取的无血管化的近端指间关节(PIP)进行稳定。材料和方法:研究队列包括8例术后患者(平均随访时间:7年),他们使用足部PIP关节重建稳定发育不全的拇指。通过测量运动范围(ROM)、拇指稳定性和长度、握力和手动操作测试的表现来评估手功能。在PIP关节摘取后通过足部检查评估供体部位的发病率。使用专门的患者报告问卷进一步分析功能结果。结果:大多数患者获得了良好的拇指稳定性和功能被动活动范围。重建拇指平均约。是正常拇指长度的75%,握力约为对侧拇指长度的50%。供体部位评估显示大多数病例脚趾缩短,但没有行走或负重缺陷。总体并发症发生率为25%,大多数患者及其家长对治疗表示满意。结论:无血管化PIP关节拇指重建增强了稳定性,减少了过度活动,其结果与类似技术报道的结果相当。这种方法为父母拒绝政治化的患者提供了一种可行的选择。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Outcomes of the toe PIP joint transfer for IIIB hypoplastic thumb: Is it justified when pollicization is denied?

Background: Amputation followed by index finger pollicization is the gold-standard treatment for type III B thumb hypoplasia. However, despite its high success rate, some parents decline this procedure because it results in a four-finger hand.

Objectives: To evaluate the outcomes of reconstructive surgery in eight patients with type III B thumb hypoplasia, stabilized using a non-vascularized proximal interphalangeal (PIP) joint harvested from the foot when parental consent for pollicization was not granted.

Material and methods: The study cohort comprised 8 postoperative patients (mean follow-up: 7 years) who underwent reconstructive stabilization of a hypoplastic thumb using a PIP joint from the foot. Hand function was evaluated by measuring range of motion (ROM), thumb stability and length, grip strength, and performance on a manual manipulation test. Donor-site morbidity was assessed via foot examination following PIP joint harvest. Functional outcomes were further analyzed using specialized patient-reported questionnaires.

Results: Most patients achieved good thumb stability and a functional passive range of motion. Reconstructed thumbs averaged approx. 75% of the length of a normal thumb, and grip strength measured about 50% of that in the contralateral hand. Donor-site assessment revealed toe shortening in the majority of cases but no deficits in ambulation or weight-bearing. The overall complication rate was 25%, and most patients and their parents reported satisfaction with the treatment.

Conclusions: Thumb reconstruction with a non-vascularized PIP joint yields enhanced stability and reduced hypermobility, with outcomes comparable to those reported for similar techniques. This approach represents a viable alternative for patients whose parents decline pollicization.

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来源期刊
Advances in Clinical and Experimental Medicine
Advances in Clinical and Experimental Medicine MEDICINE, RESEARCH & EXPERIMENTAL-
CiteScore
3.70
自引率
4.80%
发文量
153
审稿时长
6-12 weeks
期刊介绍: Advances in Clinical and Experimental Medicine has been published by the Wroclaw Medical University since 1992. Establishing the medical journal was the idea of Prof. Bogumił Halawa, Chair of the Department of Cardiology, and was fully supported by the Rector of Wroclaw Medical University, Prof. Zbigniew Knapik. Prof. Halawa was also the first editor-in-chief, between 1992-1997. The journal, then entitled "Postępy Medycyny Klinicznej i Doświadczalnej", appeared quarterly. Prof. Leszek Paradowski was editor-in-chief from 1997-1999. In 1998 he initiated alterations in the profile and cover design of the journal which were accepted by the Editorial Board. The title was changed to Advances in Clinical and Experimental Medicine. Articles in English were welcomed. A number of outstanding representatives of medical science from Poland and abroad were invited to participate in the newly established International Editorial Staff. Prof. Antonina Harłozińska-Szmyrka was editor-in-chief in years 2000-2005, in years 2006-2007 once again prof. Leszek Paradowski and prof. Maria Podolak-Dawidziak was editor-in-chief in years 2008-2016. Since 2017 the editor-in chief is prof. Maciej Bagłaj. Since July 2005, original papers have been published only in English. Case reports are no longer accepted. The manuscripts are reviewed by two independent reviewers and a statistical reviewer, and English texts are proofread by a native speaker. The journal has been indexed in several databases: Scopus, Ulrich’sTM International Periodicals Directory, Index Copernicus and since 2007 in Thomson Reuters databases: Science Citation Index Expanded i Journal Citation Reports/Science Edition. In 2010 the journal obtained Impact Factor which is now 1.179 pts. Articles published in the journal are worth 15 points among Polish journals according to the Polish Committee for Scientific Research and 169.43 points according to the Index Copernicus. Since November 7, 2012, Advances in Clinical and Experimental Medicine has been indexed and included in National Library of Medicine’s MEDLINE database. English abstracts printed in the journal are included and searchable using PubMed http://www.ncbi.nlm.nih.gov/pubmed.
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