Vilkki S K
Department of Hand and Microsurgery, Tampere University Hospital, Finland.
J Hand Surg Br. 1998 Aug;23(4):445-52. doi: 10.1016/s0266-7681(98)80120-4.
This paper presents a different technique of treatment for Bayne type IV radial club hand using a microvascular joint transfer in order to reconstruct the absent half of the wrist joint, aiming for better movement and stability at the wrist joint with preservation of longitudinal growth. The method uses preoperative soft tissue distraction to obtain proper alignment of the hand on the ulna before the second metatarsophalangeal joint with the whole metatarsal bone is transplanted. The treatment takes about 4 months and the optimum period for surgery is during the second year of life. Pollicization is added later in the normal manner. The new technique has been used in 12 cases by the author since 1987 and the results of the first nine cases are reported with a mean follow-up of 6 years. This technique appears to be promising but is demanding because of the microvascular joint transplantation at an early age.
本文介绍了一种治疗Bayne IV型桡侧先天性手畸形的不同技术，即采用微血管关节移植来重建缺失的一半腕关节，旨在实现腕关节更好的活动度和稳定性，同时保留纵向生长。该方法在移植整个跖骨的第二跖趾关节之前，利用术前软组织牵张来使手部在尺骨上获得正确对线。治疗过程约需4个月，最佳手术时机是在患儿出生后第二年。之后按常规方式进行拇指化手术。自1987年以来，作者已将这项新技术应用于12例患者，并报告了前9例患者的结果，平均随访6年。这项技术似乎很有前景，但由于在幼年时进行微血管关节移植，操作要求较高。
