From the Plastic Surgery and Burns Unit, Centre FX Michelet, Bordeaux University Hospital; Surgery School, University of Bordeaux; Service de Chirurgie Réparatrice et de la Main, Nice University Hospital; Laboratoire d'Anatomie Humaine, Faculté de Médecine de Nice; Département d'Anatomie, Faculté de médecine, Université de Lorraine; Paediatric Orthopaedic Surgery Department, Lorraine University Hospital Centre, Children's Hospital; and Department of Hand Surgery, Centre Chirurgical Emile Gallé, CHU de Nancy.
Plast Reconstr Surg. 2021 Aug 1;148(2):367-374. doi: 10.1097/PRS.0000000000008201.
Pollicization of the index finger can be considered the gold standard technique for the treatment of congenital thumb aplasia. The aim of this study was to review the described incisions for pollicization and to create an anatomical framework enabling the study and comparison of these incisions.
A systematic review was performed to collect descriptions of incision sets. An anatomical model was created from the two upper limbs of the same cadaver. Thumb aplasia was modeled on both hands of this cadaver by severing the thumbs; an index finger pollicization was performed on one of the two hands. Comparative analysis of scar positions, first web size, and neothumb aspect of each incision set was conducted using a surgical glove modeling the skin. The glove was fitted onto the aplastic model to draw the incisions and then onto the pollicized hand to adjust the resulting flaps after cutting.
Twelve articles, two textbooks, and one DVD were included in the review, either containing an original description of incisions, or describing an incision pattern with figures and references to the initial author. A total of five different incision sets, described by Buck-Gramcko, Blauth, Foucher, Ezaki, and Malek, were identified and compared using the anatomical model.
This work summarizes five original incisions described for index pollicization in thumb aplasia and presents a standardized and reliable model to study and compare these different sets. The model can be used for educational purposes, either to teach or to optimize an incision set.
食指转位术可以被认为是治疗先天性拇指发育不全的金标准技术。本研究旨在回顾描述的转位术切口，并创建一个解剖学框架，以研究和比较这些切口。
进行了系统评价以收集切口集的描述。从同一尸体的两个上肢创建了一个解剖模型。通过切断拇指在该尸体的两只手上模拟拇指发育不全；在其中一只手上进行食指转位术。使用模拟皮肤的手术手套对每个切口集的疤痕位置、第一掌间隙大小和新拇指外观进行比较分析。将手套贴合在发育不全的模型上以绘制切口，然后贴合在转位的手上以调整切割后的皮瓣。
综述中包括 12 篇文章、2 本教科书和 1 个 DVD，其中包含切口的原始描述，或通过引用初始作者的方式描述带有图形的切口模式。使用解剖模型总共确定并比较了五种不同的切口集，分别由 Buck-Gramcko、Blauth、Foucher、Ezaki 和 Malek 描述。
这项工作总结了为拇指发育不全的食指转位术描述的五种原始切口，并提出了一种标准化和可靠的模型来研究和比较这些不同的切口集。该模型可用于教学目的，无论是用于教学还是优化切口集。
