Full Description
In the past 10-15 years marked progress has been made in the surgical treatment of congenital anomalies of the hand. More and more, the reluctance to operate on these deformities has been abandoned. One reason for this - at least in the German-speaking countries - was the thalidomide catastrophe (1959-1962), which involved the birth of many children with deformed upper limbs. These previously rare severe abnormalities resulted in many problems and required new ways of thinking in terms of their treatment by all persons concerned with their care. At the same time hand surgery was beginning to come of age and the combination of these two events increased the interest in the field of hand anomalies, particularly by orthopaedic surgeons who had always been involved in it. The idea and preparation for this book go back to 1964. Since that time nearly all operations on anomalous hands were systematically charted by us. They were photographically recorded from skin incision to wound closure. Regular follow-up examinations were performed. This atlas represents our experience gained in over a thousand operations. The book has been written by practitioners. We hope that a hand surgeon looking for additional advice will find answers in regard to therapy and surgical suggestions. This intent influenced the book's compilation and structure: - Only those operations that have given us good long-term results will be discussed.
Contents
1 Introduction.- 1.1 General Directives.- 1.2 General Surgical Suggestions.- 1.3 Review of Frequent Errors of Therapy and Their Consequences.- 2 Syndactylies.- 2.1 Cutaneous Syndactylies.- 2.2 Osseous Syndactylies.- 2.3 Recurrent Syndactylies.- 3 Peripheral Hypoplasias.- 3.1 Introduction.- 3.2 Syndactyly with Digiti Superducti.- 3.3 Interdigital Cutaneous Bridge ("Bridge Syndactyly").- 3.4 Partial Syndactyly Between Thumb and Index Finger.- 3.5 Total Syndactyly of Rudimentary Fingers of Unequal Length.- 3.6 Total Syndactyly of Rudimentary Fingers of Equal Length.- 3.7 Anular Grooves with Excessive Dorsal Soft Tissue Finger Pads.- 3.8 Conical Rudimentary Finger; Excessive Dorsal Soft Tissue Finger Pad.- 3.9 Rudimentary Thumb with Excessive Soft Tissue.- 3.10 Anular Groove and Defect Pseudarthrosis of the Thumb.- 3.11 Rudimentary Index Finger with Excessive Soft Tissue and Anular Groove.- 3.12 Anular Groove of the Forearm.- 4 Numerical Variations.- 4.1 Introduction.- 4.2 Thumb Hypo- and Aplasias.- 4.3 Long Finger Oligodactylies.- 4.4 Thumb Duplication.- 4.5 Other Finger Duplications.- 5 Metrical Variations.- 5.1 Introduction.- 5.2 Dolichophalangeal Thumb.- 5.3 Brachymesophalangeal Thumb: Ulnar Clinodactyly with Wedge-Shaped Rudimentary Phalanx.- 5.4 Radial Clinodactyly Combined with Brachybasophalangy of the Thumb.- 5.5 Brachymesophalangeal Long Finger.- 6 Hypoplasias and Aplasias of Finger Joints.- 6.1 Introduction.- 7 Joint Dysplasias.- 7.1 Introduction.- 8 Symbrachydactylies.- 8.1 Introduction.- 8.2 First-Degree Symbrachydactyly Combined with Total Syndactyly of Two Long Digits and Partial Syndactyly Between Thumb and Index Finger.- 8.3 Second-Degree Symbrachydactyly Combined with "Flat Hand".- 8.4 Second-Degree Symbrachydactyly with Budlike Finger Rudiments.-8.5 Second-Degree Symbrachydactyly with Metacarpal and Syndactylous Finger Rudiments.- 8.6 Second-Degree Symbrachydactyly with Clinodactyly.- 8.7 Third-Degree Symbrachydactyly (Monodactyly).- 9 Cleft Hand.- 9.1 Introduction.- 9.2 Cleft Hand with Wide Interdigital Space.- 9.3 Lobster-Claw Hand with Thumb Clinodactyly.- 9.4 Cleft Hand with Transversal Bone.- 9.5 Cleft Hand with Total Syndactyly Between Thumb and Index Finger.- 9.6 Cleft Hand with Flexion Contracture of the Ring Finger.- 9.7 Cleft Hand with Dysplasia of the Index Finger.- 9.8 Duplication of the Proximal Thumb Phalanx, Thumb Hyperphalangia, and Partial Syndactyly I/II.- 10 Congenital Localized Giantism of the Hand (Macrodactyly).- 10.1 Introduction.- 11 Pollex Flexus Congenitus (Congenital Trigger Thumb).- 11.1 Introduction.- 11.2 Flexion Contracture of the Interphalangeal Joint of the Thumb.- 12 Camptodactyly.- 12.1 Introduction.- 13 Hypoplasias and Aplasias of the Radius (Radial Club Hand).- 13.1 Introduction.- 13.2 Radius Aplasia.- 13.3 Recurrent Club Hand.- 13.4 Radioulnar Synostosis.- 14 Hypoplasias and Aplasias of the Ulna (Ulnar Club Hand).- 14.1 Introduction.- 14.2 Ulnar Hypoplasia with Bowing of the Radius.- 15 Hereditary Multiple Exostoses.- 15.1 Introduction.- 15.2 Exostosis of a Phalanx.- 15.3 Manus Vara and Bowing of the Radius Caused by an Exostosis of the Distal Ulnar Epiphysis.- 15.4 Bowing of the Radius Caused by an Exostosis of the Metadiaphyseal Segment of the Ulna.- 15.5 Radius Shaft Exostosis (with Relative Overgrowth of the Ulna).- 16 Enchondromatosis.- 16.1 Introduction.- 16.2 Multiple Enchondromas of a Hand.- 16.3 Enchondroma of a Proximal Phalanx with Minimal Cortical Involvement.- 16.4 Large Enchondromas of the Proximal and Middle Phalanges (One-Stage Operation).- 16.5 Enchondromaof a Middle Phalanx.- 16.6 Metacarpal Enchondroma with Pathologic Fracture.- References.
