CAJ | 학술논문

目的探讨在拇指先天性多指切除矫形中将废弃赘生多指携带的血管神经束移位修复畸形拇指外形的临床应用和效果. 方法 2005年1月至2011年12月间,对6例拇指Ⅵ型多指畸形的治疗中,切除纤细和畸形的主干拇指末端部分,将生长在虎口处外形较好的赘生指截除掌骨后携带血管神经束经虎口、拇指尺侧方移位到主干拇指的末节进行固定,矫正拇指末节的外形.赘生指移位后同时进行虎口成型. 结果转移的6例拇指全部成活,4周拔除克氏针,骨断端在4～6周愈合,术后随访3个月～1年,移植拇指外形美观,拇指指腹具有原有位置的感觉,拇指抓握、对指功能良好. 结论应用显微外科技术将本应废弃的多指携带血管神经束进行移位修复主干拇指畸形,该手术方法简单易行,术后效果可靠满意,可临床推广和应用.
목적 탐토재무지선천성다지절제교형중장폐기췌생다지휴대적혈관신경속이위수복기형무지외형적림상응용화효과. 방법 2005년1월지2011년12월간,대6례무지Ⅵ형다지기형적치료중,절제섬세화기형적주간무지말단부분,장생장재호구처외형교호적췌생지절제장골후휴대혈관신경속경호구、무지척측방이위도주간무지적말절진행고정,교정무지말절적외형.췌생지이위후동시진행호구성형. 결과 전이적6례무지전부성활,4주발제극씨침,골단단재4～6주유합,술후수방3개월～1년,이식무지외형미관,무지지복구유원유위치적감각,무지조악、대지공능량호. 결론 응용현미외과기술장본응폐기적다지휴대혈관신경속진행이위수복주간무지기형,해수술방법간단역행,술후효과가고만의,가림상추엄화응용.
Objective To discuss the clinical application and therapeutic effect of repairing deformed thumb in the way of transposition of abandoned polydactyly with neurovascular bundles.Methods From January 2005 to December 2011,six cases of type Ⅳ deformities of thumb duplications were treated with excision of thin and deformed thumb phalangette of trunk,the redundant hyperdactylia,which was well-formed and involved in the first web space,was then transposed with neurovascular bundles to the thumb phalangette of trunk by the first web space and the side of thumb for fixation followed by repairation of form of thumb phalangette.The surplus metacarpal bone and phalanx of duplications were removed and the first web space was reconstructed.Results All 6 cases of heterotopic thumb phalangette transplanted to the deformed thumb phalangette were completely survived.Kirschner wires were removed 4 weeks after operation.Fracture healing occured after 4 to 6 weeks after operation.Postoperative follow-up period ranged from 3 months to 1 year.Transplanted thumbs possessed well-formed appearance with previous sensation on the finger pulp as well as excellent function of grabbing and opposing.Conclusion To repair deformity of trunk thumb in the way of microsurgery by means of transposition of duplicated thumb with neurovascular bundle which should be abandoned,is a simple operation with satisfactory and reliable postoperative effect.It shall be spred and applied.