Lundborg G, Brånemark P I, Rosén B
Department of Hand Surgery, University Hospital, Lund University, Malmö, Sweden.
J Hand Surg Am. 1996 Mar;21(2):216-21. doi: 10.1016/s0363-5023(96)80103-1.
Three patients with traumatic amputation of the thumb at the metacarpophalangeal joint level underwent a two-stage reconstruction aimed at fixation of a thumb prosthesis to the first metacarpal bone via an osseointegrated titanium fixture. The first stage included insertion of the fixture into the medullary cavity of the first metacarpal bone in combination with transplantation of cancellous bone from the iliac crest. After 3 months, when the fixture was firmly osseointegrated into the bone, a skin-penetrating abutment was placed on top of the fixture, the surrounding skin being thinned to the thickness of a split-skin graft to minimize relative mobility. A thumb prosthesis could then be firmly attached to this fixture. At follow-up examinations between 18 months and 3 years; postoperatively perfect osseointegration of the implant persisted. There were no skin problems. Some extent of tactile discrimination was achieved in the prosthesis hypothetically based on transfer of tactile stimuli to endosteal nerves in the bone via the titanium fixture.
三名掌指关节水平拇指外伤性截肢患者接受了两阶段重建手术，目的是通过骨整合钛固定装置将拇指假体固定于第一掌骨。第一阶段包括将固定装置插入第一掌骨髓腔，并结合髂骨松质骨移植。3个月后，当固定装置牢固地与骨实现骨整合时，在固定装置顶部放置一个穿透皮肤的基台，将周围皮肤削薄至断层皮片移植的厚度，以尽量减少相对移动。然后可将拇指假体牢固地连接到该固定装置上。在18个月至3年的随访检查中，植入物术后持续保持完美的骨整合。未出现皮肤问题。基于触觉刺激通过钛固定装置传递至骨内骨膜神经，假体在一定程度上实现了触觉辨别。
