Watson H K, Beebe R D, Cruz N I
J Hand Surg Am. 1984 Jul;9(4):541-7. doi: 10.1016/s0363-5023(84)80107-0.
A modified centralization procedure for radial club hand caused by partial or total absence of the radius is presented. This technique differs from the methods presently used in that no carpal bones are resected. Adequate release of the wrist from the fibrotic radial anlage is provided through two Z-plasty incisions to allow the hand to move easily to the new position. Stabilization is then obtained with a Kirschner wire placed via the lunate and capitate into the long finger metacarpal and then directed in a retrograde fashion into the ulna. A total of 12 centralization procedures with the above technique have shown very good results. Long-term follow-up results demonstrate remodeling of the ulna, which becomes broad in its distal end, resembling a radius.
本文介绍了一种针对因桡骨部分或完全缺失导致的桡侧多指畸形的改良中心化手术方法。该技术与目前使用的方法不同之处在于不切除腕骨。通过两个Z形皮瓣切口充分松解腕部与纤维化桡骨原基的粘连，以使手部能够轻松移动到新位置。然后通过克氏针经月骨和头状骨置入示指掌骨，再逆行插入尺骨以实现稳定。采用上述技术共进行了12例中心化手术，结果非常理想。长期随访结果显示尺骨发生重塑，其远端变宽，类似桡骨。
