Rider M A, Grindel S I, Tonkin M A, Wood V E
University of Sydney and the Department of Hand Surgery, Royal North Shore Hospital, Australia.
J Hand Surg Br. 2000 Aug;25(4):376-81. doi: 10.1054/jhsb.2000.0447.
This paper reviews the results of the Snow-Littler procedure performed in twelve hands with classical central longitudinal deficiency and in one hand with symbrachydactyly, cleft type. There were no instances of major flap necrosis although two flaps showed tip ischaemia. The width of the first web was, in the main, satisfactory but four webspace revisions were performed. Supplementary skin grafting at the time of surgery was necessary in complete and/or complex thumb index syndactylies and in the patient with symbrachydactyly. In eight cases, a transverse metacarpal ligament was reconstructed. In the five other cases, no clinical instability or radiological divergence of the index and ring fingers occurred, in spite of no transverse metacarpal ligament reconstruction. Three de-rotational osteotomies of transposed index fingers were performed in patients who had a transverse metacarpal ligament reconstruction. These results indicated significantly improved appearance and improved function following the Snow-Littler procedure.
本文回顾了对12例典型中央纵列缺损的手部以及1例裂手型短指畸形的手部实施Snow-Littler手术的结果。尽管有两个皮瓣出现尖端缺血，但未发生严重皮瓣坏死的情况。第一蹼的宽度总体令人满意，但进行了4次指蹼间隙修正。在完全性和/或复杂性拇指-示指并指以及短指畸形患者中，手术时需要补充植皮。8例患者重建了掌横韧带。另外5例患者尽管未重建掌横韧带，但示指和环指未出现临床不稳定或影像学分离。在进行掌横韧带重建的患者中，对3例移位示指实施了去旋转截骨术。这些结果表明，Snow-Littler手术后外观和功能均有显著改善。
