Papadogeorgou Ellada V, Soucacos Panayotis N
Department of Orthopaedic Surgery, University of Athens, School of Medicine, Athens, Greece.
Microsurgery. 2008;28(2):121-30. doi: 10.1002/micr.20463.
Congenital thumb hypoplasia is a complex and heterogeneous congenital difference that is detrimental to hand function. Apart from its' classic form, which is now considered to be part of radial dysplasia, it can occur as part of other congenital anomalies including, syndactyly, symbrachydactyly, atypical cleft hand, bifid thumb, triphalangeal thumb, mirror hand, constriction band syndrome, as well as generalized anomalies and syndromes. Management is aimed primarily at restoring basic hand function, specifically, power grasp and precision pinch, and secondarily to improve cosmoses, which inevitably is going to be impaired. Several treatment alternatives have been proposed to manage the specific disabling condition and include, 1st web space reconstruction and opponensplasty, pollicization, toe-to-hand transfer, distraction lengthening, free toe phalangeal transfer or the use of allograft, stabilization of the metacarpophalangeal joint, and surgery of "spare parts." The purpose of this study is to evaluate the various alternatives available today and propose an algorithm applicable for the appropriate management of thumb deficiency, based on their specific characteristics.
先天性拇指发育不全是一种复杂且异质性的先天性异常，对手部功能有害。除了其经典形式（现被认为是桡骨发育不全的一部分）外，它还可能作为其他先天性畸形的一部分出现，包括并指、短指畸形、非典型裂手、分叉拇指、三节拇指、镜手、束带综合征，以及全身性异常和综合征。治疗主要旨在恢复基本的手部功能，特别是强力抓握和精确捏取，其次是改善外观，而外观不可避免地会受到影响。已经提出了几种治疗方案来处理特定的致残状况，包括第一掌骨间隙重建和对掌肌成形术、拇指化、足趾到手的转移、牵张延长、游离足趾趾骨转移或使用同种异体移植物、掌指关节稳定术以及“备用部分”手术。本研究的目的是评估目前可用的各种治疗方案，并根据其具体特征提出一种适用于拇指缺如适当管理的算法。
