Iba Kousuke, Wada Takuro, Yamashita Toshihiko
Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Sapporo 060-8543, Japan.
Hand Surg. 2013;18(2):273-5. doi: 10.1142/S0218810413720192.
A three-year old patient with symbrachydactyly (didactyly type) presented with a little finger that was too short to allow pinching and consisting of a floppy soft-tissue envelope with hypoplastic phalanges, although the thumb was functional. As the proximal phalanx was too small to permit distraction lengthening or conventional bone grafting, on-top plasty using a 4th metacarpal graft with a cartilage head was undertaken for lengthening the proximal phalanx of the little finger for pinch reconstruction. At ten weeks after surgery, the patient achieved satisfactory pinch function due to the lengthened and bone-stabilised postoperative digit and reconstruction of functional proximal interphalangeal joint. In addition, the grafted metacarpal demonstrated satisfactory bone growth throughout the six-year follow-up period.
一名患有并指畸形（并指型）的三岁患者，其小指过短无法进行捏取动作，由一个松软的软组织包膜和发育不全的指骨组成，不过拇指功能正常。由于近端指骨过小，无法进行牵张延长或传统的骨移植，因此采用带软骨头的第四掌骨移植进行覆盖成形术，以延长小指近端指骨用于捏取功能重建。术后十周，由于术后手指延长且骨质稳定，以及功能性近端指间关节的重建，患者获得了满意的捏取功能。此外，在六年的随访期内，移植的掌骨显示出令人满意的骨生长情况。
