摘要目的 介绍示指拇化治疗先天性重度拇指发育不全(ⅢB～V型)的手术方法.方法 对Ⅳ型(漂浮拇)2例、ⅢB型(腕掌关节缺如)2例采用示指拇化,将示指自掌骨部位转位重建拇指.结果 4例移位指全部存活.术后随访2～3年,虎口开大70°～90°,接近健侧.拇指掌指关节屈曲后可与所有手指对指,近指间关节活动度从0°至100～120°,远指间关节活动度从0°至90°.指端两点分辨觉同健侧,外观和功能满意.结论 采用示指转位治疗重度发育不全的拇指,外形和功能满意,克服了以往采用皮瓣和骨瓣移植的缺点,是一种实用而可取的方法,值得推广.

abstractsObjective To introduce the surgical techniques of index finger pollicization for treatment of severe congenital thumb hypoplasia (type III B to V ). Methods Two cases of type IV thumb hypoplasia (floating thumb) and 2 cases of type III B thumb hypoplasia ( carpometacarpal joint absence) were treated by transferring the index finger at the level of metacarpal bone to the position of the missing thumb. Results All 4 pollicized fingers survived. The patients were followed up for 2 to 3 years postoperatively. The first web space was similar to the normal side, with maximum open degree of 70° to 90°. Range of motion of the proximal interphalangeal joint improved from 0° to 100°-120°, while that of the distal interphalangeal joint from 0° to 90°. 2-PD was the same as the normal side. The overall appearance and function were satisfaction. Conclusion Index finger pollicization can achieve satisfactory appearance and function in treating severe thumb hypoplasia. It overcomes the disadvantages of flap or osseocutaneous flap transfer. This method is practical and therefore worth of popularization.