Vilkki S K
Handchir Mikrochir Plast Chir. 1985 Mar;17(2):92-7.
A new and simplified technique for reconstruction of the gripping ability after total loss of the hand is introduced. Previous techniques have not gained popularity because of the rather complicated procedures trying to extend the stump with two additional toes. Poor skin in the distal end of the stump has been a limiting factor and technically transplantation of two separate toes has been a difficult procedure. The stability in such a grip may be compromised. In the author's modification only one toe is used with an island flap from the big toe. The opposing post in this grip is the stable resection plane of the radius, covered partly by dorsal sensible skin and partly by the first web space skin with the island flap from the big toe. The stability is good because of the width of the post. The mobility of the new "thumb" may be excellent if the balance between the different muscle transfers is optimal and the rehabilitation is done in an adequate way from the beginning. This is a preliminary report of the technique and the preliminary results in three similarly operated patients are very promising. The technique is introduced especially as a modern alternative to the Krukenberg-plasty and may have its greatest value among blind patients with long forearm stumps.
介绍了一种用于手部完全丧失后重建抓握能力的新的简化技术。先前的技术由于试图用另外两个脚趾延长残端的程序相当复杂而未得到广泛应用。残端远端皮肤状况不佳一直是一个限制因素，而且技术上移植两个单独的脚趾是一项困难的手术。这种抓握方式的稳定性可能会受到影响。在作者的改良方法中，仅使用一个脚趾，并带有来自大脚趾的岛状皮瓣。这种抓握方式中的相对支柱是桡骨的稳定切除平面，部分被背侧感觉皮肤覆盖，部分被第一蹼间隙皮肤以及来自大脚趾的岛状皮瓣覆盖。由于支柱的宽度，稳定性良好。如果不同肌肉转移之间的平衡最佳且从一开始就以适当方式进行康复，新“拇指”的活动度可能非常出色。这是该技术的初步报告，三名接受类似手术患者的初步结果非常有前景。该技术特别作为克吕肯贝格成形术的现代替代方法被引入，并且可能在患有长前臂残端的盲人患者中具有最大价值。
