Department of Orthopaedics, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
Department of Orthopaedics, Aayush Hospitals, Eluru, Andhra Pradesh, India.
J Med Case Rep. 2024 Nov 28;18(1):576. doi: 10.1186/s13256-024-04944-y.
Mirror hand is a rare congenital anomaly. Most of these cases are sporadic and associated with defective sonic hedgehog during embryogenesis. In this report, we present the case of a child with this rare congenital anomaly and its management.
A 2.5-year-old Asian female child presented with left-sided Al Qattan type 1A ulnar dimelia with restriction of wrist and elbow range of motion. Radiological examination revealed duplication of ulna with polydactyly. Management of mirror hand is a great surgical challenge, so preoperative planning and staged management is essential for the functional outcome of this condition. We successfully achieved fine and gross motor skills of the hand with acceptable cosmetic results at 2 years of follow-up.
It is crucial to remember that early intervention, ideally between 18 and 24 months of age, is key for optimal functional outcomes. Meticulous preoperative planning and surgical technique are essential. Long-term follow-up and parental counseling about the need for supervised physical therapy are important for managing secondary deformities. Additionally, digital subtraction angiography should be performed to rule out any associated neurovascular malformations.
镜像手是一种罕见的先天性畸形。这些病例大多为散发性，与胚胎发育过程中 sonic hedgehog 缺陷有关。在本报告中，我们介绍了一例罕见的先天性畸形患儿及其治疗情况。
一名 2.5 岁的亚裔女性患儿，左手存在 Al Qattan 1A 型尺侧重复，伴有腕关节和肘关节活动受限。影像学检查显示尺骨重复并伴有多指。镜像手的治疗是一项极具挑战性的手术，因此术前规划和分期管理对于改善这种情况的功能结局至关重要。我们成功地实现了手部精细运动和粗大运动技能，在 2 年的随访中获得了可接受的美容效果。
早期干预（理想情况下在 18 至 24 个月龄之间）对于获得最佳功能结局至关重要。细致的术前规划和手术技术是必不可少的。长期随访和对父母进行有关需要监督物理治疗的指导，对于管理继发性畸形非常重要。此外，应进行数字减影血管造影以排除任何相关的神经血管畸形。
