Introducing a solid model for reconstructing the severely deformed hand.
We report a case of a 39-year-old man with a severely deformed hand resulting from an injury sustained in a traffic accident at 2 years of age. A Marjolin ulcer appeared on the cicatricial area 3 years ago. After radical surgery for squamous cell carcinoma, we planned to realign the axis of the ulnarly flexed hand. Prior to surgery, we produced a solid model of the bony framework using laser lithography based on 3-D CT digital image data. The solid model furnished us and the patient with precise information on the deformity and allowed us to perform preoperative simulation surgery. By a two-stage wedge-shaped ostectomy at the end of the radius, the ulnarly deviated axis of the hand was realigned from 100 to 30 degrees (approximate) in clinical measurement and the patient was quite satisfied with the resulting function and appearance. However, there are some disadvantages of the laser lithography solid model: the cost is high, the resin material is very hard and difficult to operate on, and the model does not include soft-tissue structures. The development of a model in the future that includes vessels, nerves, and tendons will enable surgeons to transfer more precisely the results of the simulation surgery to the patient in the operating room.
Department of Plastic Surgery, Tokai University School of Medicine, Kanagawa, Japan.
R
R
Tanino
M
M
Miyasaka
T
T
Akamatsu
H
H
Taira
K
K
Ito
D000328:Adult; D006227:Hand Deformities, Acquired / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008953:Models, Anatomic; D010027:Osteotomy; D011859:Radiography