CNR ICMATE, National Research Council, Unit of Lecco, Lecco, Italy.
Department of Hand surgery and Microsurgery, University Hospital of Modena, Modena, Italy.
J Hand Surg Eur Vol. 2024 Apr;49(4):512-519. doi: 10.1177/17531934231193880. Epub 2023 Aug 22.
Thumb amputations affect 50% of hand functionality. Common solutions consist of microsurgical treatments or silicone vacuum prosthesis. Not all patients are eligible for microsurgical treatment and the use of vacuum prosthesis is often discouraged because of their instability. On the contrary, osseointegrated prosthesis provide stable retention and osseoperception. This cadaveric study evaluated the process of a patient-matched osseointegrated prosthesis for the treatment of thumb amputees. Computed tomography (CT) medical images reconstruction provided information on metacarpal stump, used as input for the parametric screw design. Preoperative planning guided the surgeons in the surgery: postoperative placement confirmed the accuracy of the preoperative planning. Surgeons were directly involved in the implant design to meet their requirements and patient needs. Implants were inserted into cadaveric specimens in one-stage surgery. A similar process can be adopted and exploited for the treatment of different levels of thumb amputations and long finger amputations.
拇指截肢影响 50%的手部功能。常见的解决方案包括显微外科治疗或硅树脂真空假体。并非所有患者都适合接受显微外科治疗,而且由于其不稳定性,真空假体的使用往往受到限制。相反,骨整合假体提供稳定的保留和骨感知。这项尸体研究评估了为治疗拇指截肢患者而定制的患者匹配骨整合假体的过程。计算机断层扫描(CT)医学图像重建提供了有关掌骨残端的信息,该信息被用作参数螺钉设计的输入。术前规划指导外科医生进行手术:术后放置确认了术前规划的准确性。外科医生直接参与植入物设计,以满足他们的要求和患者的需求。植入物在一期手术中插入到尸体标本中。可以采用类似的过程来治疗不同程度的拇指截肢和长指截肢。