Pae Woo Sik, Lin Yu-Te, Loh Charles Yuen Yung, Lee Che-Hsiung, Hsu Chung-Chen, Chen Shih-Heng, Lin Cheng-Hung
From the Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung University.
Plast Reconstr Surg. 2022 Oct 1;150(4):836-844. doi: 10.1097/PRS.0000000000009529. Epub 2022 Jul 29.
Different shapes of the proximal phalangeal head of toe proximal interphalangeal joints (e.g., oval and circular) are observed in vascularized joint transfers. The difference in shape implies the varying degrees of inclination of the articular surfaces between toes. This study investigated the impact of articular inclination on outcomes after toe joint transfers for finger proximal interphalangeal joint reconstruction.
Twenty-one patients who underwent vascularized joint transfer from May of 2009 to May of 2018 were included. Their mean age was 33.4 years and mean follow-up period was 28.9 months. All patients had a type I central slip according to the Te classification. Articular surface inclination was measured on lateral radiographic views.
Passive range of motion of the toe proximal interphalangeal joint before vascularized joint transfer was 71.1 ± 9.6 degrees. The functional range of motion of the reconstructed proximal interphalangeal joint was 60.0 ± 17.0 degrees. The extensor lag after the joint transfer was 9.4 ± 19.6 degrees. The articular inclination of the toe joint was 71.9 ± 9.7 degrees. A Pearson correlation analysis of all variables, including age, preoperative range of motion of the toe joint, postoperative range of motion of the reconstructed joint, articular inclination of the toe joint, and extensor lag of the reconstructed joint with toe articular inclination, was performed. There was no significant correlation between articular inclination of the toe joint and extensor lag of the reconstructed joint ( p = 0.226).
The articular surface inclination of the toe did not affect the functional range of motion after joint transfer.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, III.
在带血管蒂关节移植中观察到足趾近节指间关节近端指骨头有不同形状（如椭圆形和圆形）。形状差异意味着足趾间关节面的倾斜程度不同。本研究探讨关节倾斜度对足趾关节移植重建手指近节指间关节术后结果的影响。
纳入2009年5月至2018年5月接受带血管蒂关节移植的21例患者。他们的平均年龄为33.4岁，平均随访时间为28.9个月。根据Te分类，所有患者均为I型中央束损伤。在侧位X线片上测量关节面倾斜度。
带血管蒂关节移植前足趾近节指间关节的被动活动范围为71.1±9.6度。重建的近节指间关节的功能活动范围为60.0±17.0度。关节移植后的伸肌滞后为9.4±19.6度。足趾关节的关节倾斜度为71.9±9.7度。对所有变量进行Pearson相关性分析，包括年龄、术前足趾关节活动范围、术后重建关节活动范围、足趾关节关节倾斜度以及重建关节的伸肌滞后与足趾关节倾斜度的关系。足趾关节的关节倾斜度与重建关节的伸肌滞后之间无显著相关性（p = 0.226）。
足趾关节面倾斜度不影响关节移植后的功能活动范围。
临床问题/证据水平：风险，III级。
