Sieber H P, Segmüller G
Handchir Mikrochir Plast Chir. 1983 Mar;15(1):11-6.
A series of 32 arthrodeses of the interphalangeal joint of the thumb has been reviewed and the results are presented. Using a figure-of-eight wire and two crossed K-wires, the tension band principle is observed. Thus, with a minimum of material, durable stability is achieved that permits reliable healing and early use of the thumb under increasing load. The morbidity is reduced to a reasonable duration of five weeks. The angle of arthrodesis should be adapted to the professional requirements: Instrument grip (large or disc grip) is best with a small angulation of 5 to 10 degrees, while for precision grip a larger angle of 20 to 30 degrees is preferred. Tactile gnosis is best preserved when pronation of 5 to 10 degrees and slight ulnar deviation of 5 degrees of the distal phalanx in relation to the proximal phalanx is achieved. For ten years, the H-shaped incision has been used with good results in our department. However, some patients have shown anesthetic skin areas distal to the incision. We therefore have changed to a fork-shaped incision, which better preserves the cutaneous innervation.
回顾了32例拇指指间关节融合术，并给出了结果。使用8字钢丝和两根交叉克氏针，遵循张力带原则。因此，用最少的材料实现了持久的稳定性，这使得拇指在逐渐增加的负荷下能够可靠愈合并早期使用。发病率降低到合理的五周时间。关节融合角度应根据职业需求进行调整：器械握持（大握持或圆盘握持）最好采用5至10度的小角度，而精确握持则更倾向于20至30度的较大角度。当远节指骨相对于近节指骨有5至10度的旋前和5度的轻微尺偏时，触觉识别能力保存最佳。十年来，我们科室一直使用H形切口，效果良好。然而，一些患者在切口远端出现了皮肤感觉缺失区域。因此，我们改为使用叉形切口，它能更好地保留皮肤神经支配。
