Lucchina Stefano, Kanatani Takako, Guidi Marco
Hand Surgery Unit EOC, Locarno's Regional Hospital, Locarno, Switzerland.
Locarno Hand Center, Locarno, Switzerland.
Indian J Orthop. 2022 Jun 6;56(8):1464-1468. doi: 10.1007/s43465-022-00664-x. eCollection 2022 Aug.
Interphalangeal joints (IPJ) play a key role in hand function for performing activities of daily living and are frequently involved in complicated injuries resulting in significant functional limitations such as secondary arthritis and stiffness being the most challenging. In adult patients with more than 5 mm bone loss of the proximal articular surface who request a functional interphalangeal joint with minimal pain a vascularized joint transfer is a treatment choice. A unicondylar loss more than 5 mm wide in a 22-year-old carpenter is reported and illustrates our experience with a vascularized unicondylar transfer showing the advantages compared to the "classic" total joint transfer or distal interphalangeal (DIP) joint arthrodesis. By using this technique at the 12-month follow-up, we achieved no donor site complications, a good graft alignment, a good joint congruity, complete bone healing and a normal vascular patency with no signs of bone malunion or resorption of the graft.
指间关节（IPJ）在手部执行日常生活活动的功能中起着关键作用，并且经常受到复杂损伤的影响，导致严重的功能限制，如继发性关节炎和僵硬，这是最具挑战性的。对于近端关节面骨丢失超过5毫米且要求功能良好且疼痛最小的指间关节的成年患者，带血管蒂关节移植是一种治疗选择。本文报道了一名22岁木匠单髁骨丢失超过5毫米的病例，并阐述了我们采用带血管蒂单髁移植的经验，显示了与“经典”全关节移植或远侧指间关节（DIP）关节融合术相比的优势。通过在12个月的随访中使用该技术，我们未出现供区并发症，移植骨对线良好，关节匹配良好，骨完全愈合，血管通畅正常，无骨不连或移植骨吸收迹象。
