Uddin Akram, Bramall John, Santos Derek
Essex Partnership University NHS Foundation Trust & Northamptonshire Healthcare NHS Foundation Trust, UK.
Essex Partnership University NHS Foundation Trust, UK.
SAGE Open Med Case Rep. 2022 Jun 13;10:2050313X221103349. doi: 10.1177/2050313X221103349. eCollection 2022.
A 70-year-old patient was referred for a surgical opinion with a flail digit. Flail digit occurs as a result of over resection to the head of the proximal phalanx beyond the surgical neck and proximally into the shaft. The patient was complaining of a symptomatic right fourth digit (pain 7/10 on a Visual Analogue Scale) that had previously undergone two failed hammer toe surgeries resulting in symptomatic plantar hyperkeratosis with no history of ulceration or infection. The patient was surgically managed with autologous bone graft harvested from an adjacent digit biphalangic phalanx. Six months postoperative, the patient presented asymptomatic. Anatomical alignment, digital stabilisation and function were achieved. Full autologous graft consolidation was confirmed radiographically. Favourable patient-reported outcomes using the Manchester-Oxford Foot Questionnaire showed improvement in all domains. Currently, there is no published case study or description utilising our surgical technique to treat flail digit deformity.
一名70岁患者因连枷指前来寻求手术意见。连枷指是由于近端指骨头切除过多,超出手术颈部并向近端延伸至骨干所致。患者主诉右手中指有症状(视觉模拟评分法疼痛为7/10),该手指此前曾接受过两次失败的槌状趾手术,导致有症状的足底角化过度,无溃疡或感染病史。患者接受了从相邻双节指骨采集的自体骨移植手术治疗。术后6个月,患者无症状。实现了解剖学对线、手指稳定和功能恢复。影像学检查证实自体移植骨完全愈合。使用曼彻斯特-牛津足部问卷得出的患者报告良好结果显示,所有领域均有改善。目前,尚无利用我们的手术技术治疗连枷指畸形的已发表病例研究或描述。