Le Mapihan Marie, Badina Alina, Pannier Stéphanie, Salon Arielle, Glorion Chrisophe, Guero Stéphane
Hôpital Necker Enfants Malades, Service d'Orthopédie et de Traumatologie Pédiatrique, Paris, France.
J Hand Surg Eur Vol. 2020 Sep;45(7):715-721. doi: 10.1177/1753193420909784. Epub 2020 Mar 12.
In Rubinstein-Taybi syndrome, patients may have a particularly severe clinodactyly of the thumb. We evaluated a new method for correction of these severe clinodactylies using non-vascularized toe phalanx transfer as a replacement for the abnormal delta phalanx. Results of the new technique are presented, together with those of an osteotomy technique. We retrospectively recorded the angle of the clinodactyly before and after surgery and at long-term follow-up of 11 osteotomies and five transfers in nine patients from 1990 to 2017. The pre-operative angle of clinodactyli was similar between the two groups with a mean of 59°. After surgery, the correction was equivalent (7° and 11°). At the last follow-up (7 and 18 years), the relapse of clinodactyly was 17° for osteotomies and 1° for phalanx transfers. We noticed growth of the transferred phalanx, resulting in an excellent thumb length. We conclude that non-vascularized toe transfer can be an effective correction of severe clinodactyly and may be more stable than osteotomy in the long-term. IV.
在鲁宾斯坦-泰比综合征患者中，可能存在特别严重的拇指尺侧偏斜。我们评估了一种使用非血管化趾骨移植替代异常的三角骨来矫正这些严重尺侧偏斜的新方法。本文展示了新技术以及截骨术的治疗结果。我们回顾性记录了1990年至2017年9例患者中11例截骨术和5例移植手术前后以及长期随访时的尺侧偏斜角度。两组术前尺侧偏斜角度相似，平均为59°。术后矫正效果相当（分别为7°和11°）。在最后一次随访时（分别为7年和18年），截骨术组尺侧偏斜复发17°，趾骨移植组复发1°。我们注意到移植趾骨的生长，使拇指长度良好。我们得出结论，非血管化趾骨移植可有效矫正严重尺侧偏斜，且长期来看可能比截骨术更稳定。四、
