Zacharia Balaji, Puthezhath Kishore
Department of Orthopaedics, Government Medical College, Calicut, India,
Strategies Trauma Limb Reconstr. 2012 Aug;7(2):109-12. doi: 10.1007/s11751-012-0141-8. Epub 2012 Jul 24.
Swan neck thumb deformity can be caused by osteoarthritis, rheumatoid arthritis, systemic lupus erythematosus, tendon transfers and paralytic diseases. Abductor pollicis longus is one of the major stabilizing tendon of the carpometacarpal joint of thumb. To the best of our knowledge, swan neck thumb deformity owing to division of abductor pollicis longus tendon is rare. In this article, we describe a case of isolated division of abductor pollicis longus tendon presenting with swan-neck deformity of thumb and discuss the mechanism, management and outcome. The patient was treated by repair of the divided tendon using palmaris longus tendon graft. At approximately 107 weeks following treatment, the patient was having full range of thumb movement and the deformity completely disappeared. We also describe the unusual mechanism whereby an isolated division of abductor pollicis longus tendon results in swan neck thumb deformity. Level of clinical evidence IV.
鹅颈拇指畸形可由骨关节炎、类风湿关节炎、系统性红斑狼疮、肌腱转位和麻痹性疾病引起。拇长展肌是拇指腕掌关节的主要稳定肌腱之一。据我们所知，由于拇长展肌腱断裂导致的鹅颈拇指畸形很少见。在本文中，我们描述了一例因拇长展肌腱孤立性断裂而出现拇指鹅颈畸形的病例，并讨论了其机制、治疗方法和结果。该患者采用掌长肌腱移植修复断裂肌腱进行治疗。治疗后约107周，患者拇指活动范围正常，畸形完全消失。我们还描述了拇长展肌腱孤立性断裂导致鹅颈拇指畸形的不寻常机制。临床证据等级为IV级。
