Kleinman W B, Eckenrode J F
Indiana Hand Center, Indianapolis.
J Hand Surg Am. 1991 Nov;16(6):983-91. doi: 10.1016/s0363-5023(10)80056-5.
Forty consecutive tendon suspension sling arthroplasties for relief of pantrapezial osteoarthritis in 38 patients were reviewed. The procedure consists of excision of the trapezium and reconstitution of the tethering action of the first intermetacarpal and the palmar oblique carpometacarpal ligaments; 50% of the distally based flexor carpi radialis tendon is used. A double figure-eight sling suspends the first metacarpal securely, followed by distal advancement of the abductor pollicis longus to tighten the sling and palmarly abduct the thumb ray. The technique resulted in relief of pain, preservation of strength, maintenance of a normally contoured first web space, and functional carpometacarpal range of motion. Procedures were performed over a 4-year period (1986 to 1990), with an average follow-up of 21 months. At final follow-up, 85% of the patients had minimal symptoms; key pinch and grip strengths measured 76% and 81% of the contralateral uninvolved side, respectively. The logic of the mechanical design of the procedure and encouraging subjective and objective follow-up at 4 years make the technique of tendon suspension sling arthroplasty an attractive alternative to existing procedures for the surgical management of recalcitrant and disabling osteoarthritis of the basilar thumb joint.
回顾了为38例患者进行的连续40例肌腱悬吊吊带关节成形术，以缓解全舟状骨关节炎。该手术包括切除大多角骨，重建第一掌骨间和掌侧斜腕掌韧带的束缚作用；使用50%的桡侧腕屈肌腱远端。一个双“8”字吊带将第一掌骨牢固悬吊，随后拇长展肌向远端推进以收紧吊带并使拇指桡侧掌侧外展。该技术缓解了疼痛，保留了力量，维持了正常轮廓的第一掌骨间隙以及腕掌关节的功能活动范围。手术在4年期间（1986年至1990年）进行，平均随访21个月。在最终随访时，85%的患者症状轻微；捏力和握力分别为对侧未受累侧的76%和81%。该手术机械设计的合理性以及4年令人鼓舞的主观和客观随访结果，使得肌腱悬吊吊带关节成形术成为治疗顽固性和致残性拇指基底关节骨关节炎现有手术的一种有吸引力的替代方法。
