Foucher G
SOS Main, Strasbourg.
Chirurgie. 1990;116(2):176-9.
Miniaturized osteosynthesis still is the best solution for articular injuries, but in case of destruction the indications will depend on several patient-linked factors (age, handedness, profession...) and on the loss of substance. In case of limited loss of substance, Swanson's prosthesis provided an average mobility of 48 degrees at the MP level and 34 degrees at the PIP level. In case of extensive osteoarticular loss, only island or free vascularized articular transfer allow avoiding arthrodesis. The transfers provided mobility exceeding 45 degrees at the MP level and 42 degrees at the PIP level, therefore better values than with free articular toe transfers (35 degrees for the MP joints and 23 degrees for the PIP joints).
小型化接骨术仍是关节损伤的最佳解决方案,但在出现破坏的情况下,适应症将取决于几个与患者相关的因素(年龄、利手、职业等)以及骨质缺损情况。在骨质缺损有限的情况下,斯旺森假体在掌指关节水平平均活动度为48度,在近端指间关节水平为34度。在广泛的骨关节缺损情况下,只有岛状或游离带血管蒂关节移植才能避免关节融合。这些移植在掌指关节水平的活动度超过45度,在近端指间关节水平超过42度,因此比游离关节趾移植(掌指关节为35度,近端指间关节为23度)的效果更好。