Rau Johannes, Hug Urs, Löw Steffen, Unglaub Frank, Müller Lars P, Spies Christian K
Handchirurgie, SRO AG Spital Region Oberaargau, St. Urbanstr. 67, 4900, Langenthal, Schweiz.
Klinik für Plastische Chirurgie und Handchirurgie, Luzerner Kantonsspital, Haus 31, Spitalstrasse, 6000, Luzern, Schweiz.
Oper Orthop Traumatol. 2025 Feb 26. doi: 10.1007/s00064-025-00893-x.
Improving the overall function of the hand by resection of the second ray applying the palmar approach in order to achieve an aesthetically pleasing postoperative result.
Mechanically disturbing proximal limb stump, high degree of instability of the index finger, chronic infection/osteomyelitis of the index finger, dystrophic index finger with impaired circulation, degloving injury, malformations, malignant tumours of the index finger, aesthetic improvement after index finger amputation.
Loss of grip strength that cannot be tolerated.
Dissection of the index finger with resection of the second metacarpal at the proximal diametaphyseal region, mobilisation of the neurovascular bundles, and transposition of the first dorsal interosseus muscle onto the second dorsal interosseus muscle, reconstruction of the thumb-middle finger commissur.
Sufficient dressing of the thumb-middle finger commissur with immobilisation for 2-5 days, then mobilisation for 8 weeks without forceful pinch grip between thumb tip und middle finger tip, mobilisation without limits after 3 months.
After resection of the second ray, studies showed very pleasing aesthetic results with high patient satisfaction despite a decrease in grip strength.
采用掌侧入路切除第二掌骨以改善手部整体功能，从而获得美观的术后效果。
机械性干扰近端肢体残端、食指高度不稳定、食指慢性感染/骨髓炎、循环受损的营养不良性食指、脱套伤、畸形、食指恶性肿瘤、食指截肢后的美观改善。
无法耐受的握力丧失。
在近端骨干区域解剖食指并切除第二掌骨，游离神经血管束，将第一背侧骨间肌转位至第二背侧骨间肌，重建拇指 - 中指联合处。
对拇指 - 中指联合处进行充分包扎并固定2 - 5天，然后活动8周，拇指尖和中指尖之间不要用力捏握，3个月后无限制活动。
切除第二掌骨后，研究表明尽管握力有所下降，但美学效果非常令人满意，患者满意度高。
