The hand surgery department, Third Hospital of Hebei Medical University, 139 Ziqiang Rd, Qiaoxi District, Shijiazhuang, 050051 Hebei, China.
The hand surgery department, Xuzhou Renci Hospital, 11, Yangshan Road, 221002 Jiangsu, China.
Hand Surg Rehabil. 2020 Oct;39(5):417-422. doi: 10.1016/j.hansur.2020.04.006. Epub 2020 May 6.
The purpose of this study was to evaluate the use of a three-dimensional half-ring distraction frame for thumb phalangeal lengthening. From February 2009 to March 2015, 23 patients (23 thumbs) with thumb loss were treated with a half-ring distraction frame. Active movements of the metacarpophalangeal (MCP) joint were measured with a goniometer. These measurements were compared with the opposite hand. Differences were considered statistically significant at p<0.05. Clinical outcome was assessed based on the modified Mayo score. Bone union and good alignment were achieved in all patients. The mean distraction time was 44 days (range, 35-62 days). The mean time to union was 20 days (range, 49-86 days). The mean palmar and radial abduction of the thumb was 60° (range, 53°-65°) and 63° (range, 58°-70°), respectively; on the uninjured side, these measurements were 62° (range, 56°-65°) and 64° (range, 60°-73°), respectively (p>0.05). The mean extension-flexion arc of the MCP joint was 46° (range, 40°-50°); the measurement on the uninjured side was 48° (40°-54°) (p>0.05). The mean follow-up period was 51 months (4.25 years) (range, 48-65 months). The mean modified Mayo Score was 138 (range, 113-145). There were 19 excellent, 3 good, and 1 fair results. The half-ring distraction frame is a viable alternative for thumb lengthening as it provides stable, three-dimensional fixation, resulting in good hand function.
本研究旨在评估三维半环牵开架在拇指指骨延长中的应用。2009 年 2 月至 2015 年 3 月，采用半环牵开架治疗 23 例（23 拇指）拇指缺失患者。使用量角器测量掌指关节（MCP）的主动活动度。将这些测量值与对侧手进行比较。p<0.05 时认为差异具有统计学意义。根据改良 Mayo 评分评估临床结果。所有患者均获得骨愈合和良好对线。平均牵开时间为 44 天（范围 35-62 天）。平均愈合时间为 20 天（范围 49-86 天）。拇指掌侧和桡侧外展度分别为 60°（范围 53°-65°）和 63°（范围 58°-70°）；未受伤侧分别为 62°（范围 56°-65°）和 64°（范围 60°-73°），差异无统计学意义（p>0.05）。MCP 关节的屈伸弧平均为 46°（范围 40°-50°）；未受伤侧为 48°（范围 40°-54°），差异无统计学意义（p>0.05）。平均随访时间为 51 个月（4.25 年）（范围 48-65 个月）。改良 Mayo 评分平均为 138 分（范围 113-145 分）。19 例优，3 例良，1 例可。半环牵开架是一种可行的拇指延长替代方法，因为它提供了稳定的三维固定，从而获得良好的手部功能。
