Reconstruction of the Metacarpal Hand with Callotasis Lengthening Followed by Web Plasty |
Duke Whan Chung, Ki Bong Kim, Jae Ryong Cha |
가골 신연술과 물갈퀴 공간 성형술을 이용한 모든 수지가 결손된 수부의 재건 |
정덕환, 김기봉, 차재룡 |
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Abstract |
Purpose : The purpose of this study is to analyze the experience with reconstruction of the metacarpal hand through callotasis lengthening using distractive device followed by web plasty and to evaluate surgical procedure, limitation with use and outcome. Material & Methods : In retrospective study from 1991, six patients with metacarpal hands caused by posttraumatic or congenital abnormality underwent callotasis lengthening using external fixator followed by web plasty for reconstruction of prehensile function. Evaluation of the results was based on 1st web space angle, side pinch strength, activity level, two-point sensory discrimination(2PD), and objective results. Results : In all causes a spontaneous consolidation of the gap between the distracted fragments occurred. The side pinches strength results were average 0.32 kg in adults cases, able to pick-up pencil in three child cases. The mean web space angle was average 35.3 degree and 1st intermetacarpal angle for new web space was average 24.7 degree. The two-point discrimination was decreased from average 4.7 mm to average 6.7 mm at immediate postoperative state. The three patients of adults did not return to previous occupation but had to simple their work duties as labor, housework. All but two patients expressed moderate levels of satisfaction with subjective outcome and two patients is unsatisfactory to gross appearance. Conclusion : The reconstructive method with callostasis lengthening followed by web plasty is a useful treat-ment option for reconstruction of metacarpal hand caused by its hypoplastic congenital anomaly or posttraumatic injury. |
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