Poulter R J, Davis T R C
Department of Trauma and Orthopaedics, Queens Medical Campus, Nottingham University Hospitals, Nottingham, UK.
J Hand Surg Eur Vol. 2011 May;36(4):280-4. doi: 10.1177/1753193411400359. Epub 2011 Mar 3.
This study investigates the management of metacarpophalangeal joint (MCP) hyperextension in patients undergoing trapeziectomy for thumb base osteoarthritis. A total of 297 thumbs with painful trapeziometacarpal osteoarthritis were assessed on pain and thumb key and tip pinch preoperatively and at 1 year. Before surgery 101 had no MCP hyperextension, 168 had hyperextension ≤ 30° and 28 had hyperextension ≥ 35°. Of these 157 hyperextension deformities ≤ 30° and eight ≥ 35° were not treated. The others were treated by temporary insertion of a Kirschner wire (n = 9), MCP fusion (n = 6), sesamoid bone tethering to the MC head (n = 5) and palmar capsulodesis using a bone anchor (n = 11). Untreated MCP hyperextension deformities < 30° did not influence the outcome of trapeziectomy. MCP hyperextension deformities ≥ 35° can be improved by capsulodesis or MCP fusion but this may not improve the clinical outcome.
本研究探讨拇指基底骨关节炎患者行大多角骨切除术后掌指关节（MCP）过伸的处理方法。对297例患有疼痛性大多角骨掌骨关节病的拇指在术前及术后1年进行疼痛评估以及拇指捏力和指尖捏力测定。术前，101例无MCP过伸，168例过伸≤30°，28例过伸≥35°。其中，157例过伸畸形≤30°及8例≥35°未接受治疗。其余患者分别接受克氏针临时植入（n = 9）、MCP融合术（n = 6）、籽骨固定至掌骨头（n = 5）以及使用骨锚进行掌侧关节囊紧缩术（n = 11）治疗。未治疗的MCP过伸畸形<30°不影响大多角骨切除术的疗效。MCP过伸畸形≥35°可通过关节囊紧缩术或MCP融合术改善，但这可能无法改善临床疗效。
