Abstract：
OBJECTIVE: To determine whether preservation of blood supply to the index metacarpophalangeal joint decreases the rate of physeal arrest.
METHODS: A retrospective review of 41 pollicized digits in 35 patients with 2-year minimum radiographic follow-up was conducted at a single institution. Other complications evaluated included nonunion at the pollicized digit base and clinical instability at the new carpometacarpal joint. Findings were compared to historical controls, which were performed by our group prior to routine identification and sparing of the metacarpophalangeal joint blood supply. No other modifications to surgical technique were made between the previous and current patient cohorts.
RESULTS: Two pollicized digits in two different patients had radiographic evidence of physeal arrest, one of which was partial and the other complete, for an arrest rate of 4.9%. This was significantly less than the arrest rate in our historical cohort of 24.7% (21 of 85 patients). Five patients did not have radiographic bony union at the base of the index metacarpal, but only one patient had clinical instability at the new carpometacarpal joint.
CONCLUSIONS: Significantly fewer patients who underwent index finger pollicization with preservation of the metacarpophalangeal joint blood supply went on to develop physeal arrest when compared to patients who underwent pollicization prior to adoption of this technique. This finding suggests that sparing of the physeal blood supply is preventative against proximal phalanx physeal arrest.
METHODS: Therapeutic IV.
METHODS: A retrospective review of 41 pollicized digits in 35 patients with 2-year minimum radiographic follow-up was conducted at a single institution. Other complications evaluated included nonunion at the pollicized digit base and clinical instability at the new carpometacarpal joint. Findings were compared to historical controls, which were performed by our group prior to routine identification and sparing of the metacarpophalangeal joint blood supply. No other modifications to surgical technique were made between the previous and current patient cohorts.
RESULTS: Two pollicized digits in two different patients had radiographic evidence of physeal arrest, one of which was partial and the other complete, for an arrest rate of 4.9%. This was significantly less than the arrest rate in our historical cohort of 24.7% (21 of 85 patients). Five patients did not have radiographic bony union at the base of the index metacarpal, but only one patient had clinical instability at the new carpometacarpal joint.
CONCLUSIONS: Significantly fewer patients who underwent index finger pollicization with preservation of the metacarpophalangeal joint blood supply went on to develop physeal arrest when compared to patients who underwent pollicization prior to adoption of this technique. This finding suggests that sparing of the physeal blood supply is preventative against proximal phalanx physeal arrest.
METHODS: Therapeutic IV.
摘要：
目的：确定保留指掌指关节的血液供应是否会降低骨软骨阻滞的发生率。
方法：在一个机构中对35例患者进行了为期2年的最低影像学随访，对41个手指进行了回顾性回顾。评估的其他并发症包括手指底部的不愈合和新的腕掌关节的临床不稳定。研究结果与历史对照进行了比较，在常规鉴定和保留掌指关节血液供应之前，由我们的小组进行。先前和当前患者队列之间没有对手术技术进行其他修改。
结果：两名不同患者的两指有放射学证据表明有physeal骤停，其中一个是局部的，另一个是完整的，逮捕率为4.9%。这显着低于我们历史队列中的24.7％（85例患者中有21例）的逮捕率。5例患者在指骨基底没有影像学骨性愈合，但只有一名患者在新的腕掌关节出现临床不稳定。
结论：与在采用该技术之前接受波兰治疗的患者相比，在保留掌指关节血液供应的情况下接受食指波兰治疗的患者明显较少。这一发现表明，保留physeal血液供应可预防近端指骨physeal停滞。
方法：治疗IV。
方法：在一个机构中对35例患者进行了为期2年的最低影像学随访，对41个手指进行了回顾性回顾。评估的其他并发症包括手指底部的不愈合和新的腕掌关节的临床不稳定。研究结果与历史对照进行了比较，在常规鉴定和保留掌指关节血液供应之前，由我们的小组进行。先前和当前患者队列之间没有对手术技术进行其他修改。
结果：两名不同患者的两指有放射学证据表明有physeal骤停，其中一个是局部的，另一个是完整的，逮捕率为4.9%。这显着低于我们历史队列中的24.7％（85例患者中有21例）的逮捕率。5例患者在指骨基底没有影像学骨性愈合，但只有一名患者在新的腕掌关节出现临床不稳定。
结论：与在采用该技术之前接受波兰治疗的患者相比，在保留掌指关节血液供应的情况下接受食指波兰治疗的患者明显较少。这一发现表明，保留physeal血液供应可预防近端指骨physeal停滞。
方法：治疗IV。
