Tsai T M, McCabe S, Beatty M E
Department of Orthopedic Surgery, University of Louisville School of Medicine, KY 40202.
Microsurgery. 1987;8(3):146-53. doi: 10.1002/micr.1920080308.
Amputation of the thumb, including the basal joint, is a disabling injury that leaves limited reconstructive options. Three cases of multiple digit amputation including the thumb and basal joint are presented in which a second toe transfer was used to reconstruct the thumb. All patients have functional pinch with an average pinch strength of 27% of the opposite uninjured extremity. The average grip strength for two patients is 44% of the opposite hand. Average motion of the transfer at the MP, PIP, and DIP is 25 degrees, 37 degrees, and 9 degrees, respectively. Adduction and abduction are obtained, the degree depending on the site of proximal bony fixation. No patient has morbidity at the donor site and all are happy with their reconstruction. In selected cases we feel second toe transfer is an excellent choice to reconstruct the thumb amputated at a proximal level.
拇指截肢，包括掌指关节截肢，是一种致残性损伤，可供选择的重建方法有限。本文介绍了3例包括拇指和掌指关节在内的多指截肢病例，均采用第二趾移植重建拇指。所有患者均具备功能性捏力，平均捏力为对侧未受伤肢体的27%。两名患者的平均握力为对侧手的44%。移植趾在掌指关节、近端指间关节和远端指间关节处的平均活动度分别为25度、37度和9度。可实现内收和外展，其程度取决于近端骨固定的部位。所有供区均无并发症，患者对重建效果均满意。对于某些特定病例，我们认为第二趾移植是重建近端水平拇指截肢的理想选择。
