足趾移植を行った手と筋電義手の機能差—両手切断の1症例

The Functional Difference between Two Hands, One Treated by a Toe-to-finger Transfer and the other with a Myo-electric Hand Prosthesis: A Case Report of Bilateral Hand Amputation

はじめに

　指の欠損に対して足趾移植で治療し，手，前腕の欠損に義手を用いることは良く行われる．ローラーによる両手の挫滅切断に対して片手を足趾移植で，もう片手を筋電義手で治療し，その使用状況から両治療手段の機能的差異を観察したので報告する．

Abstract : A 45-year old male patient suffered mutilation of his fingers except for the thumb in the right hand, and a crush injury of the whole left hand simultaneously while operating a rolling machine. The right hand was reconstructed with a double 2nd-toe implantation. After training his pinch motion in the right hand, a myoelectric prosthesis was attached to the left hand. He used his right hand for pinching task and the left hand for grasping task. His DASH score was 173 before functional reconstruction of the bilateral hands, and it was 84 at 5 years after treatment. A comparison was made concerning the functional results between the right hand reconstructed with the toe transfer and the left hand with the myoelectric prosthesis in order to discuss the prognosis for each treatment.