Foucher G, Chabaud M
SOS Main, Strasbourg, France.
Plast Reconstr Surg. 1998 Nov;102(6):1981-7. doi: 10.1097/00006534-199811000-00026.
The authors describe a new technique for reconstruction of the thumb after amputation through the proximal phalanx. Bipolar lengthening is a combination of first web deepening by an Ostrowski flap and a distal lengthening by a free vascularized compound transfer of pulp, nail, and bone harvested longitudinally from the distal phalanx of the great toe. Seven cases have been reviewed by an independent observer after a mean follow-up of 46 months. There were no technical failures. The mean static 2-point discrimination was 6.3 mm, and the Semmes-Weinstein monofilament testing was identical to that of the contralateral side in four patients and increased in the other three. After correction for hand dominance, grip strength was 89 percent of that of the contralateral side, and pinch strength was 81 percent of that of the contralateral side. First web span was symmetric in four patients and diminished in the other three. The bipolar technique creates a short thumb, which avoids exposing the thumb to trauma when making a fist, without limiting first web span.
作者描述了一种用于拇指经近节指骨截肢后重建的新技术。双极延长术是一种联合手术，包括通过奥斯特罗夫斯基皮瓣加深第一掌骨间隙以及通过游离带血管的复合组织移植进行远节延长，该复合组织由从拇趾远节指骨纵向切取的指腹、指甲和骨组成。一名独立观察者对7例患者进行了回顾，平均随访46个月。无技术失败病例。平均静态两点辨别觉为6.3毫米，4例患者的Semmes-Weinstein单丝试验结果与对侧相同，另外3例有所增加。校正手优势后，握力为对侧的89%，捏力为对侧的81%。4例患者的第一掌骨间隙对称，另外3例变窄。双极技术形成一个短拇指，在握拳时可避免拇指受到创伤，同时不限制第一掌骨间隙。
