Cross Andrew W, Schmidt Christopher C
Allegheny Hand Center, Allegheny General Hospital, Pittsburgh, PA 15212, USA.
J Hand Surg Am. 2008 Feb;33(2):164-7. doi: 10.1016/j.jhsa.2007.11.011.
We present 2 cases showing that flexor pollicis longus and flexor digitorum profundus index injury can occur after placement of 2 commonly used locked volar plates. In contrast with the literature, the radii healed in an anatomic position without plate lift-off. The patients presented 6 and 8 months after surgery with new onset of radial wrist pain and tenderness at the site of the plate and absence or weakness of the flexor pollicis longus. In both cases, the plate was positioned anterior to the distal radial rim on the lateral radiograph. We suggest close follow-up of all fractures in which the distal end of the plate is anterior to the radial rim and removal of hardware if symptoms suggest tendon irritation.
我们报告2例病例,显示在使用2种常用的掌侧锁定钢板后,可发生拇长屈肌和示指深屈肌损伤。与文献报道不同的是,桡骨在解剖位置愈合,未出现钢板移位。患者分别在术后6个月和8个月出现桡腕关节新发性疼痛,钢板部位压痛,拇长屈肌缺失或无力。在这2例病例中,侧位X线片显示钢板位于桡骨远端边缘前方。我们建议,对于钢板远端位于桡骨边缘前方的所有骨折均应密切随访,若出现肌腱刺激症状,则取出内固定物。