Wood V E, Rubinstein J H
J Hand Surg Br. 1987 Jun;12(2):166-72. doi: 10.1016/0266-7681_87_90005-2.
In a review of 530 individuals with Rubinstein-Taybi syndrome, 182 (34%) were found to have thumbs in severe radial angulation ("hitch-hiker thumbs"), which prevented opposition and functional gripping strength. Surgery has been performed on 35 thumbs (from 20 patients), usually to correct a delta phalanx deformity. The preferred approach was a closing wedge osteotomy, with a Z-plasty on the concave side to straighten the thumb. In eight and possibly 11 of the 35 thumbs, the angulation deformity or stiffness recurred, emphasizing the importance of proper and careful surgery. We conclude that surgical correction of the deformity is best done before the age of two, so that the thumb is functional during the initial development of hand-eye coordination. Deviation persisting at the age of ten can be corrected by fusing the metacarpophalangeal joint.
在一项对530例鲁宾斯坦-泰比综合征患者的回顾研究中，发现182例（34%）患者的拇指存在严重的桡侧成角（“搭便车者拇指”），这妨碍了对掌功能和抓握力。已对35例拇指（来自20名患者）进行了手术，通常是为了矫正三角指骨畸形。首选方法是闭合楔形截骨术，在凹侧进行Z成形术以矫正拇指。在35例拇指中，有8例可能还有11例出现了成角畸形或僵硬复发，这强调了正确且谨慎手术的重要性。我们得出结论，畸形的手术矫正最好在两岁之前进行，以便拇指在手眼协调的初始发育阶段发挥功能。十岁时仍存在的偏斜可通过融合掌指关节来矫正。
