Slade J F, Gutow A P
Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven, Connecticut, USA.
Hand Clin. 1999 Aug;15(3):501-27.
The refinement of technology with improved lighting and smaller optics has made possible new techniques of MCP joint arthroscopy. It is the mastery of the unique anatomy of these different--not just smaller--joints, however, that permits the applications of these new skills. Arthroscopy of the MCP joint permits the diagnosis of pathology not well visualized by other means, and the treatment of these lesions with minimal soft tissue disruption. The authors' experience with arthroscopically aided reduction of fractures of the MCP joint has shown it to be as good as or better than open repair of these fractures. The authors have found the same to be true in treating ulnar collateral ligament injuries of the thumb. Although there is a learning curve with small joint arthroscopy, when the team and surgeon are familiar with the new routines and instruments, the time to accomplish the tasks quickly decreases and is often shorter than that for standard open procedures. The authors' experience suggests that the application of these techniques can allow treatment of MCP pathology with fewer complications than open approaches and may result in improved final function.
照明的改善和光学元件的小型化使得技术得以改进，从而催生了掌指关节镜检查的新技术。然而，正是对这些不同（不仅仅是更小）关节独特解剖结构的掌握，才使得这些新技能得以应用。掌指关节镜检查能够诊断出其他方法难以清晰显示的病变，并能在对软组织破坏最小的情况下治疗这些病变。作者在关节镜辅助下复位掌指关节骨折方面的经验表明，其效果与开放性修复这些骨折相当或更好。作者发现，在治疗拇指尺侧副韧带损伤方面也是如此。尽管小型关节镜检查存在学习曲线，但当团队和外科医生熟悉新的操作流程和器械后，完成任务的时间会迅速缩短，而且往往比标准开放性手术的时间更短。作者的经验表明，应用这些技术治疗掌指关节病变时，并发症比开放性手术少，最终功能可能会得到改善。
