Falliner A, Blauth W, Olason A T
Orthopädische Universitätsklinik Kiel.
Z Orthop Ihre Grenzgeb. 1988 May-Jun;126(3):239-49. doi: 10.1055/s-2008-1040198.
The authors report on experience gained in the surgical treatment of eight patients with congenital hallux varus associated with polydactyly of the big toe. Aside from a description of the "radiological anatomy", the paper focuses in particular on the intraoperative soft tissue findings. In addition to the supernumerary bone structures, muscle and tendon anomalies were found in all the patients. In four patients the cause of the varus malposition was found to be fibrous stands extending from the rudimentary big toe to the tarsus. In five patients the abductor hallucis muscle was found to be shortened. An analysis of the surgical results shows that these soft tissue changes must be taken into account during surgery. In addition to complete removal of the polydactylic supernumerary, fibrous strands must be resected and shortened muscles severed or elongated. In many cases, operations on the basal joint capsule and plastic surgery are also necessary.
作者报告了对8例先天性拇内翻合并拇趾多指畸形患者进行手术治疗的经验。除了对“放射解剖结构”的描述外，本文特别关注术中软组织的发现。除了多余的骨结构外，所有患者均发现肌肉和肌腱异常。在4例患者中，发现内翻畸形的原因是从发育不全的拇趾延伸至跗骨的纤维束。在5例患者中，发现拇展肌缩短。对手术结果的分析表明，手术过程中必须考虑这些软组织变化。除了完全切除多指多余部分外，还必须切除纤维束，切断缩短的肌肉或进行延长。在许多情况下，还需要对基底关节囊进行手术和整形手术。
