Takagi Takehiko, Nojiri Ayano, Seki Atsuhito, Takayama Shinichiro, Watanabe Masahiko
Department of Orthopaedic Surgery, Surgical Science, Tokai University School of Medicine, Kanagawa, Japan.
Department of Orthopaedic Surgery, National Center for Child Health and Development, Setagaya-ku, Tokyo, Japan.
J Hand Surg Am. 2017 Jul;42(7):575.e1-575.e5. doi: 10.1016/j.jhsa.2017.02.005. Epub 2017 Mar 17.
A patient with upper limb dimelia including a double scapula, humerus, radius, and ulna, 11 metacarpals and digits (5 on the superior side, 6 on the inferior side) was treated with a simple amputation of the inferior limb resulting in cosmetic improvement and maintenance of range of motion in the preserved limb. During the amputation, the 2 limbs were found to be anatomically separate except for the ulnar nerve, which, in the superior limb, bifurcated into the sensory branch of radial nerve in the inferior limb, and the brachial artery, which bifurcated into the radial artery. Each case of this rare anomaly requires its own individually carefully planned surgical procedure.
一名患有上肢重复畸形的患者,包括双侧肩胛骨、肱骨、桡骨和尺骨,11块掌骨和手指(上侧5个,下侧6个),接受了下肢简易截肢术,术后外观得到改善,保留肢体的活动范围得以维持。截肢过程中发现,除尺神经外,双下肢在解剖学上相互独立。在该患者上肢,尺神经分叉,其分支在下肢成为桡神经感觉支;肱动脉也发生分叉,其分支成为桡动脉。每例这种罕见畸形都需要单独精心规划手术方案。