McDonald Thomas J, James Michelle A, McCarroll H Relton, Redlin Hillary
Department of Orthopaedics, University of California at Davis, Sacramento, CA 95817-2201, USA.
Tech Hand Up Extrem Surg. 2008 Jun;12(2):79-84. doi: 10.1097/BTH.0b013e31815aea4f.
The management of the hypoplastic thumb depends on the degree of bony malformation, soft tissue anomaly, and deficiencies. Type IIIA thumbs have thumb-index web-space narrowing, hypoplasia of the thenar musculature, metacarpophalangeal joint instability, and extrinsic tendon abnormalities. They also have a hypoplastic metacarpal with a stable carpometacarpal joint, differentiating them from type IIIB thumbs which have an unstable carpometacarpal joint due to partial metacarpal aplasia. Whereas type IIIB thumbs are best treated with ablation and index pollicization, type IIIA thumbs are amenable to reconstruction. Many techniques have been described for correction of the variety of deformities found in theses thumbs. The purpose of this article is to present our preferred technique for comprehensive reconstruction of type IIIA thumbs.
发育不全拇指的治疗取决于骨畸形、软组织异常及缺损的程度。ⅢA型拇指存在拇指-示指蹼间隙变窄、大鱼际肌发育不全、掌指关节不稳定及外在肌腱异常。它们还具有发育不全的掌骨，其腕掌关节稳定，这使其与ⅢB型拇指相区别，ⅢB型拇指由于部分掌骨发育不全而存在不稳定的腕掌关节。ⅢB型拇指最佳治疗方法是切除并进行示指拇指化，而ⅢA型拇指适合进行重建。针对这些拇指中发现的各种畸形，已有许多技术被描述。本文的目的是介绍我们用于ⅢA型拇指全面重建的首选技术。
