Immediate Autologous Fillet Bone Grafting for Thumb Metacarpal Defect in a Severe Mangled Hand

嚴重手部壓碎傷以立即自體廢物利用骨移植重建一大拇指缺損

蔡文平(Wen-Ping Tsai) ； 謝式洲(Shyh-Jou Shieh) ； 李經維(Jing-Wei Lee) ； 邱浩遠(Haw-Yen Chiu)

《中華民國整形外科醫學會雜誌》 15卷1期 (2006/03) Pp. 61-67

https://doi.org/10.7096/JPSA.200603.0061

摘要

嚴重手部開放式壓碎傷合併骨缺損對於手外科醫師是個具挑戰性的臨床難題。雖然對於這類傷害有許多重建選擇，立即一階段去填補骨缺損及解剖學復位似乎是個理想的方式，而從其他截肢組織取出自體移植骨的幫助可以達到此目標。
我們報告一個嚴重開放式手部傷害合併第一掌骨骨缺損的病例，為了保留大拇指及手部的功能，從無法拯救預計截肢的食指近位指骨取出自體移植骨以重建大拇指之掌骨及基底關節。術後一年的追蹤，這個植入的移植骨與第一掌骨有良好的癒合且基底關節活動良好，病患在功能上獲得令人滿意的結果。

並列摘要

Severe mutilating open injuries of hand with bone loss are challenging clinical problems for hand surgeons. Though there are many reconstructive options for these injuries, immediate and one stage bony defect restoration with anatomical reduction seem to be an ideal method. It can be accomplished with the help of autologous bone graft from other amputated part of hand.
We report a case of severe open hand injury with first metacarpal bone loss. To preserve thumb as well as hand function, autologous bone graft for metacarpal and basal joint reconstruction of thumb was harvested from proximal phalanx of ipsilateral index finger which was destined for amputation due to unsalvageable of the second ray. The interposed bone graft incorporated well into first metacarpal bone and basal joint function was restored in one year follow-up. Functional results were achieved satisfactorily.

並列關鍵字

fillet bone graft ； mangled hand injury ； metacarpal reconstruction