摘要
目的介绍拇指单纯掌板损伤致掌指关节交锁的诊治方法。方法对11例拇指掌指关节有过伸受伤和体征的患者,结合X线片和掌指关节造影的辅助诊断,采用局部麻醉进行闭合复位,2例获得成功,9例失败而行切开复位。结果术后11例获得4～28个月的随访．平均13个月。治疗后拇指掌指关节交锁无复发,掌指关节屈曲35°～60°,平均400(少于健侧10°)。2例持重物时略有疼痛。结论根据外伤、手部体征,结合影像学检查,掌板损伤不难做出诊断。可先在局麻下手法复位。若不成功,则手术松解,可以取得满意的疗效。
Objective To introduce the diagnosis and treatment of locking of the metacarpophalangeal joint （MPJ） of the thumb caused by isolated rupture of the volar plate .Methods 11 cases were involved in the study,7 male and 4 female.The average age was 37 years（ranging from 19 to 51 years）.In all the patients the MPJ locking had resulted from forced hypertemsion of the thumb,The mean time from injury to clinic was 19 days （range：1-35 days）.Two cases were seen over 30 days.Typical signs were seen in all the cases with hyperextension of the MPJ and flexion of the interphalangeal joint.There was no positive sign on X-ray but mild hyperextersion derormity of the MPJ on the lateral view.All the patients received manual reduction under local anaesthesia.But only two were successful.Operation was performed in 9 cases .There was rupture at pmximal volar plate transversely with its distal part riding over the volar prominence of the radial condyle of the metacarpal together with the accessory collateral ligament.These dislocated parts of the ligament formed a constricting budle on the sistal joint surface of the condyle that prevented closed reduction.The locking was released by cutting the constricted ligament bundle.Results The mean follow -up time was 13 months （4-28months）.The mean range of flexio of the MPJ was 40°（35-60°）.10°less than the contralateral side.There was mild pain in two cases while holding heavy subjects.Conclusion Diagnosis can be made depending on the injury history and typical sign of MPJ of the thumb.Operation should be performed when manual reduction fails.
出处
《中华手外科杂志》
CSCD
北大核心
2006年第2期95-96,共2页
Chinese Journal of Hand Surgery
关键词
掌指关节
治疗结果
掌板
metacarpophalangeal joint
Treatment outcome
Volar plate
