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使用显微镜的新型微创指间关节融合术方法

Novel Minimally Invasive Approach for Arthrodesis in Distal Interphalangeal Joint Using Microscope.

作者信息

Hachisuka Hiroki, Okuhara Atsushi, Munemori Masaru, Ishibashi Shigeki, Adachi Nobuo

机构信息

From the Department of Orthopaedic Surgery, Akane Medical Corporation Tsuchiya General Hospital, Hiroshima Hand and Microsurgery Center, Hiroshima, Hiroshima, Japan.

Department of Orthopaedic Surgery, Hiroshima Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Hiroshima, Japan.

出版信息

Plast Reconstr Surg Glob Open. 2025 Feb 20;13(2):e6553. doi: 10.1097/GOX.0000000000006553. eCollection 2025 Feb.

Abstract

Arthrodesis is a definitive treatment for osteoarthritis of the distal interphalangeal (DIP) joint. The surgical approach is generally performed from the dorsal side of the DIP joint using a Y- or H-shaped incision. However, this approach can lead to relatively noticeable scarring and dorsal tissue complications. We introduced a microsurgery technique to address patients' desire for cosmetic improvement in addition to pain relief. In our modified approach, a small 1.5-cm skin incision was made along the mid-lateral line of the finger. This approach allows for a safer and faster synovectomy, osteophyte resection, and osteotomy in a limited surgical field. The joint was fixed by using a headless screw. In this article, we describe the application of this method for DIP arthrodesis. Our study included 12 women with a mean age of 63 years (51-83 y) and a mean follow-up period of 6 months (3-12 mo). All patients expressed satisfaction with the results. Bone union was successfully achieved in all fingers, leading to the resolution of pain without complications. The average postoperative score on the short version of the Disabilities of the Arm, Shoulder, and Hand questionnaire was 0. These findings suggest that the microsurgical approach is a minimally invasive and effective method for treating DIP arthrodesis.

摘要

关节融合术是治疗远侧指间(DIP)关节骨关节炎的一种确定性治疗方法。手术入路通常是通过在DIP关节背侧采用Y形或H形切口进行。然而,这种方法可能会导致相对明显的瘢痕形成和背侧组织并发症。除了缓解疼痛外,我们引入了一种显微外科技术来满足患者对改善美观的需求。在我们改良的方法中,沿着手指的中外侧线做一个1.5厘米的小皮肤切口。这种方法在有限的手术视野内能够更安全、更快地进行滑膜切除术、骨赘切除术和截骨术。关节通过使用无头螺钉进行固定。在本文中,我们描述了这种方法在DIP关节融合术中的应用。我们的研究纳入了12名女性,平均年龄63岁(51 - 83岁),平均随访期6个月(3 - 12个月)。所有患者对结果表示满意。所有手指均成功实现骨愈合,疼痛得以缓解且无并发症。手臂、肩部和手部功能障碍问卷简版的术后平均评分为0分。这些发现表明,显微外科手术方法是治疗DIP关节融合术的一种微创且有效的方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8d1/11841839/608aee196b76/gox-13-e6553-g001.jpg

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