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[采用拇外展肌腱改良重建侧副韧带治疗拇指腕掌关节慢性桡侧不稳]

[Modified collateral ligament reconstruction with the tendon of the abductor pollicis tendon in treatment of chronic radial instability of the basal thumb joint].

作者信息

Warzecha J, Lennert K H

机构信息

Abteilung für Chirurgie, Frankfurter Diakoniekliniken Bethanienkrankenhaus.

出版信息

Handchir Mikrochir Plast Chir. 2001 Mar;33(2):117-20. doi: 10.1055/s-2001-12298.

Abstract

Injuries to the radial collateral ligament of the MP joint of the thumb occur much less frequently than injuries to the ulnar collateral ligament. Ligament injury is usually a result of direct trauma. The resultant instability to the thumb usually impairs hand function. In acute lesions to the radial collateral ligament, direct repair is often possible. In cases of chronic radial joint instability, secondary ligament reconstruction with a free tendon graft, most commonly the palmaris longus tendon, is usually recommended. We describe another technique using the tendon insertion of the abductor pollicis brevis muscle. The tendon inserting distally can be used as a stable ligament after dividing it at the border to the muscle and attaching it to the head of the metacarpal bone with a wire. The follow-up for six patients treated by this method showed good and painless stability and function of the thumb in a time span of one year.

摘要

拇指掌指关节桡侧副韧带损伤的发生率远低于尺侧副韧带损伤。韧带损伤通常是直接创伤的结果。由此导致的拇指不稳定通常会损害手部功能。对于桡侧副韧带的急性损伤,通常可以直接修复。在慢性桡关节不稳定的情况下,通常建议使用游离肌腱移植进行二期韧带重建,最常用的是掌长肌腱。我们描述了另一种使用拇短展肌肌腱止点的技术。在距肌肉边界处切断向远端走行的肌腱后,可将其用作稳定的韧带,并通过钢丝将其附着于掌骨头部。对采用该方法治疗的6例患者进行随访,结果显示在一年的时间内拇指具有良好且无痛的稳定性和功能。

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Chronic finger joint instability reconstructed with bone-ligament-bone graft from the iliac crest.
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