Damsin J P, Ghanem I
Department of Orthopedic Surgery, Hôpital d'Enfants Armand Trousseau, Paris, France.
Hand Clin. 2000 Nov;16(4):685-701.
Congenital deficiencies and developmental deformities of the upper extremity often result in complex deformities that include, to variable degrees, shortening and angulation. Because of the nonweight-bearing status of the upper extremity, these deformities are better tolerated and often of less functional significance than their counterparts in the lower extremity. The need for lengthening therefore is less common in the upper extremity than in the lower extremity. When planning a lengthening procedure to the upper limb, the surgeon must be aware of some specific indications, goals, and complications. In the final analysis, one must weigh the risk of upper limb lengthening against the benefits. In fact, there are many pitfalls, and it is not a surgery to be undertaken lightly. In the hands of experienced specialists, it can achieve excellent results. The potential complication rate is high initially, but tends to diminish with increasing experience. The authors believe that the functional, cosmetic, and psychological benefits of upper limb lengthening outweigh the risk of permanent sequelae and functional impairment in selected patients.
上肢的先天性缺陷和发育畸形常导致复杂畸形，不同程度地包括缩短和成角。由于上肢不负重，这些畸形比下肢的同类畸形更易耐受，且功能意义通常较小。因此，上肢延长的需求比下肢少见。在计划上肢延长手术时，外科医生必须了解一些特定的适应证、目标和并发症。归根结底，必须权衡上肢延长的风险与益处。事实上，存在许多陷阱，这不是一个可以轻易进行的手术。在经验丰富的专家手中，它可以取得优异的效果。最初潜在并发症发生率较高，但随着经验增加往往会降低。作者认为，在特定患者中，上肢延长的功能、美容和心理益处超过永久性后遗症和功能损害的风险。
