Ding Zhenyu, Zhu Xiaozhong, Fu Kai, Zheng Xianyou
Department of Orthopedics, Shanghai Jiaotong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai 200233, China.
Biomed Res Int. 2017;2017:4934280. doi: 10.1155/2017/4934280. Epub 2017 Feb 12.
We evaluated the results of digital lengthening by distraction and second-stage bone graft. We treated finger deficiency of 201 digits in 104 patients (68 males, 36 females) by digital distraction and second-stage bone graft. The distraction was performed with a rate of 1 mm/day (for the first ten days) and 0.5 mm/day followed by using a self-designed bilateral tubal-helical external fixator. The mean follow-up period was 42 months (range 6 to 60 months). The mean lengthening was 29.2 mm (range 25 to 40 mm) and 18.7 mm (range 12 to 32 mm) for metacarpal bones and phalanges, respectively. The mean elongation rate was 174.4% (range 145% to 202%) and 184.8% (range 115% to 283%) for metacarpal bones and phalanges, respectively. The static two-point discriminations and SpO showed no significant differences before and after distraction. Four complications were observed (two skin ruptures and two phalangeal splitting). No pin tract infection or tendon rupture showed. Digital lengthening improved functions of the hand. Digital distraction and second-stage bone graft is an effective method to compensate disabilities caused by lack of finger length. It could be an alternative plan for patients with thumb deficiency instead of toe-to-thumb transplant and patients with finger deficiency instead of ray resection.
我们评估了通过牵张和二期植骨进行手指延长的效果。我们采用手指牵张和二期植骨治疗了104例患者（68例男性，36例女性）的201个手指缺损。牵张速率为1毫米/天（前10天），之后为0.5毫米/天，采用自行设计的双侧管状螺旋外固定器。平均随访时间为42个月（范围6至60个月）。掌骨和指骨的平均延长分别为29.2毫米（范围25至40毫米）和18.7毫米（范围12至32毫米）。掌骨和指骨的平均延长率分别为174.4%（范围145%至202%）和184.8%（范围115%至283%）。静态两点辨别觉和血氧饱和度在牵张前后无显著差异。观察到4例并发症（2例皮肤破裂和2例指骨劈裂）。未出现针道感染或肌腱断裂。手指延长改善了手部功能。手指牵张和二期植骨是补偿手指长度不足所致残疾的有效方法。对于拇指缺损患者，它可以作为替代拇趾移植的方案；对于手指缺损患者，它可以作为替代射线切除的方案。
