Berkay Fehmi, Schneider Andrew, Minhas Arjun, Wimalawansa Sunishka
Wright State University Boonshoft School of Medicine, Department of Orthopaedic Surgery and Plastic Surgery, Dayton, Ohio.
JBJS Case Connect. 2024 Mar 14;14(1). doi: 10.2106/JBJS.CC.23.00390. eCollection 2024 Jan 1.
A 23-year-old right-hand dominant man presented with a high-velocity gunshot wound injury to the right thumb with severe soft-tissue damage, vascular injury, and large osseous defect of the right thumb metacarpal. The patient was successfully treated with metacarpophalangeal joint arthrodesis and metacarpal reconstruction using definitive external fixation, an intramedullary Kirschner wire, and use of the Masquelet bone grafting technique.
The authors' treatment approach for a mangled thumb injury with definitive external fixation and utilization of the Masquelet technique resulted in restoration of a large osseous defect, avoidance of infection, and limited loss of mobility.
一名23岁惯用右手的男性因右手拇指遭受高速枪伤前来就诊，伴有严重的软组织损伤、血管损伤以及右手拇指掌骨的大骨缺损。该患者通过掌指关节融合术、使用确定性外固定、髓内克氏针以及应用Masquelet骨移植技术成功进行了掌骨重建。
作者采用确定性外固定和运用Masquelet技术治疗严重毁损拇指损伤，实现了大骨缺损的修复，避免了感染，且活动度丧失有限。
