Kallemeier Patricia M, Manske Paul R, Davis Benjamin, Goldfarb Charles A
Department of Orthopaedic Surgery, Washington University School of Medicine at Barnes Jewish Hospital, St. Louis, MO, USA.
J Hand Surg Am. 2007 Nov;32(9):1408-12. doi: 10.1016/j.jhsa.2007.08.011.
A relationship between symbrachydactyly and transverse deficiency has been suggested but has not been critically investigated or established by scientific studies. The purpose of this investigation was to evaluate a large group of patients with transverse deficiency of the forearm for clinical and radiologic features typically seen in patients with symbrachydactyly.
A retrospective review of the medical records of 291 patients with a diagnosis of upper-extremity transverse deficiency at the level of the forearm was performed. Patient charts, photographs, and radiographs were evaluated for manifestations of symbrachydactyly; specifically, we clinically assessed for the presence of nubbins and skin invaginations and radiologically assessed for hypoplasia of the proximal radius and ulna.
Two hundred seven patients had soft tissue nubbins at the end of their amputation stumps including 38 with the additional finding of skin invagination at the distal end. Another 36 extremities had a skin invagination alone. Twenty-nine of the extremities without nubbins or skin invaginations had hypoplasia of the proximal radius and ulna. Thus, 272 of the 291 extremities with transverse deficiency had manifestations of symbrachydactyly.
The majority of patients with the diagnosis of transverse deficiency have soft tissue nubbins, skin invaginations, or hypoplasia of the proximal radius and ulna at the end of their amputation stumps. These clinical and radiologic features support the concept that transverse deficiency through the forearm represents a proximal continuum of symbrachydactyly.
有人提出短指畸形与横断性缺损之间存在关联，但尚未经过严格调查或科学研究证实。本研究的目的是评估一大组前臂横断性缺损患者，以观察短指畸形患者常见的临床和放射学特征。
对291例诊断为前臂水平上肢横断性缺损的患者病历进行回顾性研究。对患者病历、照片和X光片进行短指畸形表现的评估；具体而言，我们临床评估有无残端小肉赘和皮肤凹陷，放射学评估近端桡骨和尺骨发育不全情况。
207例患者截肢残端末端有软组织小肉赘，其中38例在远端还有皮肤凹陷这一额外表现。另外36个肢体仅有皮肤凹陷。29个既无小肉赘也无皮肤凹陷的肢体存在近端桡骨和尺骨发育不全。因此，291个横断性缺损肢体中有272个有短指畸形表现。
大多数诊断为横断性缺损的患者在截肢残端末端有软组织小肉赘、皮肤凹陷或近端桡骨和尺骨发育不全。这些临床和放射学特征支持这样一种观点，即前臂的横断性缺损是短指畸形在近端的延续。
