Hunt Thomas R
Division of Orthopaedic Surgery, The University of Alabama, Birmingham School of Medicine, 930 Faculty Office Tower, 510 20th Street South, 35294-3409, USA.
Hand Clin. 2006 May;22(2):221-8. doi: 10.1016/j.hcl.2006.02.004.
Symptomatic post-traumatic arthritis affecting the finger CMC joints is less common than might otherwise be expected based on the frequency of injury, especially to the fifth CMC joint. For the fifth CMC joint, the shallow concavoconvex articulation combined with the typical fracture location may provide a protective effect. Non-operative measures are typically successful, except in cases of missed fracture/dislocations and symptomatic joint instability. In these instances, re-construction emphasizes stability first, with an eye toward mobility for the ulnar column. It is common to detect a bony prominence in the region of the dorsal second and third CMC joints during examination of the hand. In most instances, the projection is asymptomatic and likely represents an os styloideum [18]. When painful and unresponsive to nonoperative treatments, this carpometacarpal boss can be excised surgically.
有症状的创伤后关节炎累及手指掌指关节（CMC）不如根据损伤频率所预期的那么常见，尤其是第五掌指关节。对于第五掌指关节，浅的凹凸关节面结合典型的骨折部位可能起到保护作用。非手术措施通常是成功的，除非存在漏诊的骨折/脱位以及有症状的关节不稳定情况。在这些情况下，重建首先强调稳定性，同时着眼于尺侧柱的活动度。在手部检查时，常在第二和第三掌指关节背侧区域检测到骨性隆起。在大多数情况下，这种突出是无症状的，可能代表茎突骨[18]。当疼痛且对非手术治疗无反应时，这种腕掌骨隆突可通过手术切除。
