Paediatria Croatica, Vol. 66 No. 3-4, 2022.
Stručni rad
https://doi.org/10.13112/PC.2022.13
Staged reconstruction of radial longitudinal deficiency and thumb aplasia – case report and a review of the literature
Rok Kralj
; Klinika za dječje bolesti Zagreb
Karlo Tadić
; Medicinski fakultet Sveučilišta u Zagrebu, Šalata 3b, Zagreb
Mario Kurtanjek
; Klinika za dječje bolesti Zagreb
Daniel Max Weber
; Hand Surgery Department, Division of Pediatric surgery, University Children’s Hospital Zürich, Steinwiesstrasse 75, Zürich
Stjepan Višnjić
; Klinika za dječje bolesti Zagreb
Sažetak
Purpose: Presentation of surgical treatment of a girl with type IV radial longitudinal deficiency and type IV thumb hypoplasia as well as review of the most relevant literature published in the previous 25 years.
Methods: The treatment consisted of placement of an external fixator and subsequent distraction in the radioulnar and proximodistal axis as the initial procedure followed by radialization according to Buck-Gramcko around the 2nd birthday, 10 weeks after the primary procedure. The last step of the treatment was a pollicization of the index finger performed before the 4th birthday.
Results: The surgical treatment resulted with a very favorable outcome – a clinically stable wrist, radiologically well aligned carpus over the ulna and an index pollicised in such a manner that enables adequate opposition to the other fingers.
Conclusion: A review of literature in the last 25 years shows that radialization of the ulna with a preceding distraction offers benefits over centralization alone. Distraction of the wrist protects the distal ulnar growth plate and thus promotes growth. Soft tissue release with a bilobar flap can also provide a good outcome as wells as a microvascular joint transfer from the 2nd toe whereas the latter requires advanced microsurgical skills.
Ključne riječi
SURGICAL PROCEDURES, OPERATIVE; THUMB; ABNORMALITIES
Hrčak ID:
296401
URI
Datum izdavanja:
29.12.2022.
Posjeta: 891 *