Hanel D P, Lederman E S
Department of Orthopaedic Surgery, Medical College of Wisconsin, Milwaukee.
J Hand Surg Am. 1993 Mar;18(2):271-7. doi: 10.1016/0363-5023(93)90360-F.
Ten patients underwent index-to-long-finger ray transposition for repair after resection of the long finger ray. Care was taken to preserve the second web space and prevent painful neuromas. Rigid internal fixation was achieved with a T plate, and mobilization was started immediately. There were no nonunions. Postoperative motion was equal to preoperative motion in acute cases and equal or better in chronic cases. Mean grip strength was 0.65, and pinch strength was 0.78 compared with the uninjured hand. There were no painful neuromas, hypersensitive scars, or deterioration of monofilament or two-point sensibility. The breadth and appearance of the first and second web spaces were equal bilaterally. Digit alignment and rotation were normal. The six patients receiving worker's compensation returned to work in between 3 and 24 weeks, and the other patients returned in between 11 days and 12 weeks.
10例患者在切除示指掌骨后接受示指至中指掌骨转位修复。术中注意保留第二指间蹼间隙并预防疼痛性神经瘤。采用T形钢板实现坚强内固定，并立即开始活动。未发生骨不连。急性病例术后活动度与术前相同，慢性病例术后活动度相同或更佳。与健侧手相比，平均握力为0.65，捏力为0.78。未出现疼痛性神经瘤、瘢痕过敏或单丝或两点辨别觉恶化。双侧第一和第二指间蹼间隙的宽度和外观相等。手指对线和旋转正常。6例领取工伤赔偿的患者在3至24周之间重返工作岗位，其他患者在11天至12周之间重返工作岗位。
