Hame S L, Melone C P
Beth Israel Medical Center, New York, New York, USA.
Am J Sports Med. 2000 Nov-Dec;28(6):879-82. doi: 10.1177/03635465000280061701.
Injuries to the extensor mechanisms of the fingers can be career-ending in professional athletes if not treated appropriately. We identified 8 professional athletes who underwent 11 direct metacarpophalangeal joint extensor mechanism repairs including centralization of the extensor tendon and sagittal band repair between 1989 and 1994. Success of the operative procedure was determined by the athlete's attainment of full range of motion, return to professional sports, and no need for additional surgical intervention. The metacarpophalangeal joints of the long and little fingers were most commonly involved. The position of the extensor mechanism disruption and the direction of the tendon subluxation varied. Capsular tears were identified in seven joints and none were repaired. At follow-up, each athlete had regained full range of motion and each had returned to professional sport an average of 5 months postoperatively. No patient required additional surgery. In this series, the principal lesion in metacarpophalangeal joint injury was extensor mechanism disruption with a predictable sagittal band tear and either a radial or ulnar subluxation of the central tendon. We recommend centralization of the extensor tendon and sagittal band repair without capsular repair as a treatment of choice for this injury, particularly in the athlete.
手指伸肌机制损伤若处理不当，对于职业运动员来说可能会终结其职业生涯。我们确定了8名职业运动员，他们在1989年至1994年间接受了11次掌指关节伸肌机制直接修复手术，包括伸肌腱中心化和矢状带修复。手术的成功取决于运动员是否达到了全关节活动范围、是否重返职业运动以及是否无需额外的手术干预。示指和小指的掌指关节最常受累。伸肌机制中断的位置和肌腱半脱位的方向各不相同。在7个关节中发现了关节囊撕裂，但均未进行修复。随访时，每名运动员均恢复了全关节活动范围，且平均在术后5个月重返职业运动。没有患者需要再次手术。在本系列研究中，掌指关节损伤的主要病变是伸肌机制中断，伴有可预测的矢状带撕裂以及中央肌腱的桡侧或尺侧半脱位。我们建议将伸肌腱中心化和矢状带修复而不进行关节囊修复作为该损伤的首选治疗方法，尤其是对于运动员。
