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拇指桡侧籽骨骨折:一种不常见的骨折。

Fracture of the radial sesamoid bone of the thumb: an unusual fracture.

作者信息

Deabate Luca, Garavaglia Guido, Lucchina Stefano, Fusetti Cesare

机构信息

Department of Orthopaedic and Trauma Surgery EOC-ORBV Via ospedale, 1 CH-6500 Bellinzona, Switzerland.

出版信息

Chin J Traumatol. 2011;14(5):309-11.

Abstract

The hand consists of five sesamoids. Two of them are present at the metacarpophalangeal (MCP) joint of the thumb. Fracture of the sesamoid bones of the thumb is a rare injury and the literature on the radial side is seldom reported. We reported a case of a patient with a fracture of the radial sesamoid at the MCP joint of the thumb in order to increase attention regarding this type of injuries. A 44-year-old male, high level gymnastic trainer, was helping one of his athletes during an exercise while he reported a hyperextension trauma to the MCP joint of the right thumb. One week after trauma, he presented to the hand surgeon complaining of a painful thumb at the MCP joint level on its palmar aspect. Standard A-P and lateral X-rays revealed a fracture of the radial sesamoid and the fracture was treated with a splint for 3 weeks. He was able to resumed his entire work 6 weeks after the injury. The sesamoid fractures is an indicator of the magnitude of the hyperextension injury and sometimes associated with tears of the volar plate ligament of the MCP joint. And a failure to recognize the ligament injury may lead to a long-term hyperextension instability on pinching.

摘要

手部由五块籽骨组成。其中两块位于拇指的掌指关节处。拇指籽骨骨折是一种罕见的损伤,关于桡侧籽骨骨折的文献报道很少。我们报告了一例拇指掌指关节桡侧籽骨骨折的患者,以提高对这类损伤的关注。一名44岁的男性,高级体操教练,在帮助一名运动员进行训练时,右手拇指掌指关节遭受过度伸展创伤。创伤一周后,他前往手外科就诊,主诉拇指掌指关节掌侧疼痛。标准前后位和侧位X线片显示桡侧籽骨骨折,骨折用夹板固定3周。受伤6周后他能够恢复全部工作。籽骨骨折是过度伸展损伤严重程度的一个指标,有时与掌指关节掌板韧带撕裂有关。未能识别韧带损伤可能导致捏物时长期的过度伸展不稳定。

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