Akmaz Ibrahim, Kiral Ahmet, Pehlivan Ozcan, Solakoğlu Can
GATA Haydarpaşa Eğitim Hastanesi Ortopedi ve Travmatoloji Kliniği, Istanbul, Turkey.
Acta Orthop Traumatol Turc. 2003;37(3):237-43.
We evaluated the results of ligament reconstruction performed for chronic instability of the traumatic thumb carpometacarpal joint.
Seven male patients with traumatic instability of the thumb carpometacarpal joint underwent ligament reconstruction with the use of the technique described by Eaton and Littler. The mean duration between the traumatic event and the operation was eight months. According to the radiological criteria by Eaton and Littler, five patients had stage I, and two patients had stage II disease. The mean follow-up period was 23 months. The results were assessed according to the criteria by Lane and Eaton.
Postoperatively, the patients' grip strength and pinch strength increased by a mean of 40.4% (range 31% to 50%) and 75.4% (range 62% to 100%), respectively. No increases in the extent of arthrosis were observed in the carpometacarpal joint during the follow-up period. None of the patients developed morbidity associated with the functions of the flexor carpi radialis and the wrist. The results were excellent in four, and good in three patients. No complications occurred such as infection or recurrent instability, nor were there any problems related to the skin and Kirschner wires.
Ligament reconstruction for the carpometacarpal joint of the thumb relieves pain and restores stability while preserving a functional range of motion in patients with chronic instability.
我们评估了针对创伤性拇指腕掌关节慢性不稳定进行韧带重建的结果。
7例患有拇指腕掌关节创伤性不稳定的男性患者采用伊顿（Eaton）和利特勒（Littler）描述的技术进行了韧带重建。创伤事件与手术之间的平均时间为8个月。根据伊顿和利特勒的放射学标准，5例患者为I期，2例患者为II期疾病。平均随访期为23个月。根据莱恩（Lane）和伊顿的标准对结果进行评估。
术后，患者的握力和捏力平均分别增加了40.4%（范围为31%至50%）和75.4%（范围为62%至100%）。随访期间，腕掌关节未观察到关节病程度增加。没有患者出现与桡侧腕屈肌和腕部功能相关的并发症。4例患者结果为优，3例为良。未发生感染或复发性不稳定等并发症，皮肤和克氏针也未出现任何问题。
对于慢性不稳定的患者，拇指腕掌关节韧带重建可缓解疼痛并恢复稳定性，同时保留功能活动范围。
