体験する手外科 第3巻
先天異常・小児疾患編
本シリーズは，手外科診療の十分な経験と機会に恵まれない先生方への1つの「思考トレーニングツール」として企画され，第1巻「外傷編」は大好評！ 第2巻「変性疾患・腫瘍編」および第3巻では更に深く掘り下げ，ボリューム満点となった。「今最も多くの症例を持つ著者の先天異常手に対する熱い思いと手技」「先天異常手術の微妙なタッチを紙上にかくも見事に再現した渾身の1冊！」 第4巻「珠玉の症例編」は2025年発刊予定！
はじめに ······························································································· ⅰ
本書の使い方 ························································································ ⅱ
動画の閲覧方法 ···················································································· ⅵ
Case31 ４歳 男児 左母指運動障害（伸展制限） ······················· 2
関連症例① ５歳 女児 両側母指伸展制限 ······························································· 8
関連症例② ５歳 男児 両側母指IP関節伸展制限，右母指IP関節橈屈変形 ····················· 14
関連症例②’ ６歳 女児 両側母指IP関節伸展制限，右母指IP関節橈屈変形 ····················· 16
関連症例③ ９歳 男児 両側母指の可動域制限（屈曲障害） ········································ 21
関連症例④ ９歳 男児 両側母指の可動域制限（屈曲障害） ········································ 27
Case32 ２カ月 女児 両側母指伸展制限 ······································· 40
関連症例① ５歳 男児 両側母指伸展制限，第１指間の狭小化 ···································· 45
関連症例② 29歳 男性 両側母指痛，伸展制限 ······················································· 49
関連症例③ 13歳 男性 右母指伸展外転制限 ·························································· 52
Case33 ５カ月 女児 左母指が１本多い ······································· 64
関連症例① ５カ月 男児 右母指が１本多い ·························································· 73
関連症例② ４カ月 男児 左母指が１本多い ·························································· 81
関連症例③ １歳１カ月 男児 右母指が１本多く，曲がっている ·································· 86
関連症例④ 14歳 女性 左母指が曲がっている，不安定でぐらぐらする ························ 92
追加症例① １歳 男児 右母指が１本多い ··························································· 107
追加症例② １歳６カ月 女児 右母指が１本多い ··················································· 111
追加症例③ １歳６カ月 女児 右母指が１本多い，左母指の爪幅が広い ······················· 112
追加症例④ １歳２カ月 女児 右母指が１本多い ··················································· 116
Case34 １歳１カ月 女児 両手足の指が癒合している ············ 120
関連症例① 11カ月 女児 両側中・環指の癒合 ····················································· 128
関連症例② １歳４カ月 男児 左中・環指の癒合 ··················································· 134
関連症例③ １歳３カ月 女児 両側中・環指の癒合，両足の指が多い ·························· 138
追加症例 １歳 男児 右中・環指の癒合 ··························································· 151
Case35 ５歳２カ月 男児 左手が小さい ······································· 158
関連症例① ２歳４カ月 男児 左手が小さい ························································· 166
関連症例② ９カ月 男児 両手の変形 ································································· 170
関連症例③ １歳６カ月 女児 左手の低形成・変形 ················································ 178
追加症例① １歳２カ月 男児 右手の低形成・変形 ················································ 186
追加症例② １歳２カ月 男児 左手の低形成・合指症 ·············································· 190
Case36 １歳４カ月 女児 右手指の欠損 ····················································· 198
関連症例① １歳６カ月 男児 右環指と小指の指間が深い ········································ 204
関連症例② １歳４カ月 男児 右中指欠損 ···························································· 207
関連症例③ １歳３カ月 男児 左中指欠損と手掌の裂，右示・中指の癒合 ···················· 211
関連症例④ １歳 男児 両足の変形（右左ともに指が癒合している） ··························· 217
追加症例 10歳 男児 右中指の欠損 ································································ 229
Case37 ２歳７カ月 男児 右母指がブラブラしている ············ 236
関連症例① 13歳 女性 両側母指が動きづらくなってきた ······································· 243
関連症例② ８カ月 男児 左手指の欠損 ······························································ 250
関連症例③ １歳６カ月 男児 右手指の欠損 ························································· 254
Case38 ６歳９カ月 男児 両側小指が曲がっている ················ 270
関連症例① 12歳５カ月 女児 両側小指が曲がっている ··········································· 273
関連症例② ２歳６カ月 男児 左示指が曲がって短い ·············································· 278
関連症例③ ２カ月 男児 両側示・中指が伸びない ················································ 282
関連症例④ ４歳６カ月 女児 両側小指が伸びない ················································ 285
関連症例⑤ 16歳 女性 右小指が動きづらい ························································ 290
追加症例 ５歳 男児 右母指が短く曲がっている ················································ 294
Case39 ２歳６カ月 女児 右小指をカッターで切った ············ 302
関連症例① ７歳 男児 右手関節部の切創 ··························································· 308
関連症例② 11歳 男児 右中指の痛み ································································ 313
関連症例③ 12歳 女児 左示指の痛みと腫れ ························································ 316
関連症例④ 12歳 男児 左示・環指の痛みと腫れ ·················································· 319
追加症例 10歳 女児 左中指の運動障害・疼痛 ·················································· 329
Case40 １歳６カ月 男児 左手の癒合・ひきつれ ····················· 336
関連症例① １歳３カ月 女児 両手指の完全な癒合 ················································ 342
関連症例② ６歳 女児 右環指の変形 ································································ 352
関連症例③ ４歳 男児 右示指PIP関節の屈曲拘縮 ················································ 360
追加症例① 11歳 女児 左示指の軽度の拘縮 ························································ 368
追加症例② １歳９カ月 女児 両手の拘縮 ···························································· 373
コーヒーブレイク
▶「ムンテラ」と「インフォームドコンセント（IC ）」 ·································· 39
▶ 手塚治虫と今の科学 ··············································································· 156
▶「神は細部に宿る」 ················································································· 157
▶ 勝ちに不思議の勝ちあり，負けに不思議の負けなし ································ 235
▶ Be water ································································································ 269
▶ 必要なのは「心」「技」「体」 ··································································· 300
▶ 念仏を唱える？ ······················································································ 301
▶ ジャネーの法則とPERFECT DAYS ·························································· 335
▶ 落合的医師指導論··················································································· 379
▶ 君たちはどう生きるか（最後のコラム） ··················································· 380
ミニコラム
▶ 母指多指症と豊臣秀吉 ·············································································· 98
症例疾患診断名一覧 ·················································································· 381
INFORMATION ························································································· 382
あとがき ···································································································· 384
事項索引 ···································································································· 385
著者紹介 ···································································································· 391
第４巻：「珠玉の症例」編 ※2025年発売予定
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「体験する手外科」シリーズはこれまで２冊を刊行してきました。幸い数多くの方々に実際に手に取って体験していただき，とても好評でたくさんの反響をいただきました。読者の皆さまをはじめ関係各位にこの場を借りて感謝申し上げます。このたび，さらにパワーアップして「体験する手外科」第３巻・先天異常・小児疾患編を刊行することができました。これで手外科のほとんどの分野がカバーできる形になります。
手は狭く小さな器官であるものの，外傷，炎症，変性疾患，絞扼性神経障害，麻痺手，腫瘍，先天異常など疾患は多岐にわたります。この第３巻は先天異常・小児疾患編として，頻度の多いものからマニアックなものまで幅広く扱っています。また私，本来の専門が上肢先天異常であるためか，今まで以上に熱のこもった内容になりました。当初は15症例を準備していましたが，あれもこれもと欲張ってしまったために内容が膨大になりました。そこで泣く泣く10症例に絞ることにし，ようやく１冊にまとめることができました。本書に掲載できなかった体験は今後WEBなどで公開したいと思います。
今までも述べてきましたが，手外科を普段から診療している整形外科医や形成外科医でも，系統立ったトレーニングを受け，手外科専門医に向けた研鑽を積むことは容易ではありません。手外科は必要不可欠な分野であるものの，その診療経験を十分に積むことは困難であり，手外科専門医を目指す環境に恵まれていない人が多いのが現状です。それをなんとかしたい一心で今まで努めてきました。
本書を体験して手外科を習得したうえで，手外科専門医取得の一助となればこれほど素晴らしいことはありません。この「体験」を元に，明日の手外科診療を担ってほしいです。
これから10人以上の患者さんが参ります。東北ハンドサージャリーセンター（東北大学関連病院や仙台医療センター）で私が実際体験した5,000以上の症例から症例を厳選しました。さあ，実際に診療するつもりで，この症例たちを「体験」してください！
2024年２月22日
鳥谷部 荘八