目的 探討克氏針絲線張力帶治療拇指掌指關(guān)節(jié)尺側(cè)副韌帶撕脫骨折的臨床療效。 方法 2008年9 月-2011年10月,收治14例拇指掌指關(guān)節(jié)尺側(cè)副韌帶撕脫骨折患者。男8例,女6例;年齡23~55歲,平均40.8歲。致傷原因:機(jī)器扭轉(zhuǎn)傷5例,人力扭轉(zhuǎn)傷4例,跌傷4例,運(yùn)動傷1例。受傷至手術(shù)時間2 h~14 d?;颊吣粗刚浦戈P(guān)節(jié)疼痛,活動受限,掌指關(guān)節(jié)尺側(cè)側(cè)方應(yīng)力試驗(yàn)陽性。采用克氏針絲線張力帶固定骨折,2周后開始功能鍛煉。 結(jié)果術(shù)后切口均Ⅰ期愈合,拇指掌指關(guān)節(jié)尺側(cè)側(cè)方應(yīng)力試驗(yàn)陰性。患者均獲隨訪,隨訪時間6~18個月,平均13.1個月。X線片檢查示骨折復(fù)位、愈合良好,愈合時間為4~10周,平均7周。末次隨訪時,患指掌指關(guān)節(jié)屈伸活動穩(wěn)定,對指功能正常,手指抓捏功能正常。按照Saetta等標(biāo)準(zhǔn)評價術(shù)后功能,獲優(yōu)11例,良3例,優(yōu)良率達(dá)100%。 結(jié)論克氏針絲線張力帶具有手術(shù)操作簡便、術(shù)后功能鍛煉早、功能恢復(fù)滿意的優(yōu)點(diǎn),是治療拇指掌指關(guān)節(jié)尺側(cè)副韌帶撕脫骨折的有效方法之一。
引用本文: 高順紅馮仕明焦成. 克氏針絲線張力帶治療拇指掌指關(guān)節(jié)尺側(cè)副韌帶撕脫骨折. 中國修復(fù)重建外科雜志, 2012, 26(12): 1466-1468. doi: 復(fù)制
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2. | Tang P. Collateral ligament injuries of the thumb metacarpophalangeal joint. J Am Acad Orthop Surg, 2011, 19(5): 287-296. |
3. | Papandrea RF, Fowler T. Injury at the thumb UCL: is there a Stener lesion? J Hand Surg (Am), 2008, 33(10): 1882-1884. |
4. | Chuter GS, Muwanga CL, Irwin LR. Ulnar collateral ligament injuries of the thumb: 10 years of surgical experience. Injury, 2009, 40(6): 652-656. |
5. | Ritting AW, Baldwin PC, Rodner CM. Ulnar collateral ligament injury of the thumb metacarpophalangeal joint. Clin J Sport Med, 2010, 20(2): 106-112. |
6. | Anderson D. Skier’s thumb. Aust Fam Physician, 2010, 39(8): 575-577. |
7. | Frank WE, Dobyns J. Surgical pathology of collateral ligamentous injuries of the thumb. Clin Orthop Relat Res, 1972, (83): 102-114. |
8. | Camp RA, Weatherwax RJ, Miller EB. Chronic posttraumatic radial instability of the thumb metacarpophalangeal joint. J Hand Surg (Am), 1980, 5(3): 221-225. |
9. | Saetta JP, Phair IC, Quinton DN. Ulnar collateral ligament repair of the metacarpo-phalangeal joint of the thumb: a study comparing two methods of repair. J Hand Surg (Br), 1992, 17(2): 160-163. |
10. | Smith RJ. Post-traumatic instability of the metacarpophalangeal joint of the thumb. J Bone Joint Surg (Am), 1977, 59(1): 14-21. |
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13. | Baskies MA, Lee SK. Evaluation and treatment of injuries of the ulnar collateral ligament of the thumb metacarpophalangeal joint. Bull NYU Hosp Jt Dis, 2009, 67(1): 68-74. |
14. | Rettig A, Rettig L, Welsch M. Anatomic reconstruction of thumb metacarpophalangeal joint ulnar collateral ligament using an interference screw docking technique. Tech Hand Up Extrem Surg, 2009, 13(1): 7-10. |
15. | Katolik LI, Friedrich J, Trumble TE. Repair of acute ulnar collateral ligament injuries of the thumb metacarpophalangeal joint: a retrospective comparison of pull-out sutures and bone anchor techniques. Plast Reconstr Surg, 2008, 122(5): 1451-1456. |
16. | Watanabe K. A simple method of osteosynthesis for avulsion fractures of the thumb metacarpophalangeal joint. Hand Surg, 2005, 10(2-3): 209-211. |
- 1. Patel S, Potty A, Taylor EJ, et al. Collateral ligament injuries of the metacarpophalangeal joint of the thumb: a treatment algorithm. Strategies Trauma Limb Reconstr, 2010, 5(1): 1-10.
- 2. Tang P. Collateral ligament injuries of the thumb metacarpophalangeal joint. J Am Acad Orthop Surg, 2011, 19(5): 287-296.
- 3. Papandrea RF, Fowler T. Injury at the thumb UCL: is there a Stener lesion? J Hand Surg (Am), 2008, 33(10): 1882-1884.
- 4. Chuter GS, Muwanga CL, Irwin LR. Ulnar collateral ligament injuries of the thumb: 10 years of surgical experience. Injury, 2009, 40(6): 652-656.
- 5. Ritting AW, Baldwin PC, Rodner CM. Ulnar collateral ligament injury of the thumb metacarpophalangeal joint. Clin J Sport Med, 2010, 20(2): 106-112.
- 6. Anderson D. Skier’s thumb. Aust Fam Physician, 2010, 39(8): 575-577.
- 7. Frank WE, Dobyns J. Surgical pathology of collateral ligamentous injuries of the thumb. Clin Orthop Relat Res, 1972, (83): 102-114.
- 8. Camp RA, Weatherwax RJ, Miller EB. Chronic posttraumatic radial instability of the thumb metacarpophalangeal joint. J Hand Surg (Am), 1980, 5(3): 221-225.
- 9. Saetta JP, Phair IC, Quinton DN. Ulnar collateral ligament repair of the metacarpo-phalangeal joint of the thumb: a study comparing two methods of repair. J Hand Surg (Br), 1992, 17(2): 160-163.
- 10. Smith RJ. Post-traumatic instability of the metacarpophalangeal joint of the thumb. J Bone Joint Surg (Am), 1977, 59(1): 14-21.
- 11. Dinowitz M, Trumble T, Hanel D, et al. Failure of cast immobilization for thumb ulnar collateral ligament avulsion fractures. J Hand Surg (Am), 1997, 22(6): 1057-1063.
- 12. Kozin SH, Bishop AT. Tension wire fixation of avulsion fractures at the thumb metacarpophalangeal joint. J Hand Surg (Am), 1994, 19(6): 1027-1031.
- 13. Baskies MA, Lee SK. Evaluation and treatment of injuries of the ulnar collateral ligament of the thumb metacarpophalangeal joint. Bull NYU Hosp Jt Dis, 2009, 67(1): 68-74.
- 14. Rettig A, Rettig L, Welsch M. Anatomic reconstruction of thumb metacarpophalangeal joint ulnar collateral ligament using an interference screw docking technique. Tech Hand Up Extrem Surg, 2009, 13(1): 7-10.
- 15. Katolik LI, Friedrich J, Trumble TE. Repair of acute ulnar collateral ligament injuries of the thumb metacarpophalangeal joint: a retrospective comparison of pull-out sutures and bone anchor techniques. Plast Reconstr Surg, 2008, 122(5): 1451-1456.
- 16. Watanabe K. A simple method of osteosynthesis for avulsion fractures of the thumb metacarpophalangeal joint. Hand Surg, 2005, 10(2-3): 209-211.