Persitz Jonathan, Paul Ryan, Tamir Eran, Avisar Erez
Hand Program, Division of Plastic, Reconstructive and Aesthetic Surgery, University Health Network, Toronto Western Hospital, Affiliated with Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Department of Orthopaedic Surgery, Foot and Ankle Surgery Unit, Yitzhak Shamir Medical Center, Zerifin, Israel, Affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
J Orthop Case Rep. 2024 May;14(5):99-103. doi: 10.13107/jocr.2024.v14.i05.4448.
Patients facing post-traumatic malunion or congenital hand differences often contend with functional and cosmetic issues. Traditional correction methods involve open osteotomy, marked by drawbacks like scarring, non-union risks, prolonged rehabilitation, and adhesions. We therefore introduce a novel minimally invasive technique called Minimally Invasive Corrective Osteotomy of the Hand (MICO), which can be performed under local anesthesia. MICO employs a low-speed, high-torque burr to address finger malunions and congenital anomalies.
A 49-year-old male patient, generally healthy and right hand dominant, presented with a post-traumatic left middle finger, middle phalanx malunion who underwent the MICO procedure, with a 1-year post-operative follow-up.
Our findings suggest that MICO offers a straightforward, reproducible, and delicate solution for correcting hand malunions and congenital finger deformities, potentially mitigating the well-established disadvantages and complications associated with the traditional open approach. Although early results of MICO are promising, a larger case series is needed to evaluate the superiority of this technique compared with current open corrective osteotomy methods.Level of Evidence: IV.
面临创伤后畸形愈合或先天性手部差异的患者常常要应对功能和美观问题。传统的矫正方法包括开放性截骨术,其缺点有瘢痕形成、不愈合风险、康复时间延长和粘连等。因此,我们引入了一种名为手部微创矫正截骨术(MICO)的新型微创技术,该技术可在局部麻醉下进行。MICO采用低速、高扭矩磨钻来处理手指畸形愈合和先天性异常。
一名49岁男性患者,总体健康,惯用右手,因创伤后左手中指中节指骨畸形愈合前来就诊,接受了MICO手术,并进行了术后1年的随访。
我们的研究结果表明,MICO为矫正手部畸形愈合和先天性手指畸形提供了一种直接、可重复且精细的解决方案,有可能减轻与传统开放手术相关的既定缺点和并发症。尽管MICO的早期结果很有前景,但需要更大规模的病例系列来评估该技术与当前开放矫正截骨术方法相比的优越性。证据级别:IV级。