Moneim Moheb S, Morrell Nathan T, Mercer Deana M
Department of Orthopaedics and Rehabilitation, 1 University of New Mexico, Albuquerque, NM.
Tech Hand Up Extrem Surg. 2014 Sep;18(3):116-20. doi: 10.1097/BTH.0000000000000048.
Osteoarthritis of the thumb trapeziometacarpal (basal) joint is a very common problem facing the hand and upper extremity surgeon. Many surgical procedures have been described with varied results. We present the surgical technique--partial trapeziectomy with capsular interposition arthroplasty--used by the senior author over the last 10 years. The essential steps of the procedure are: bony resection of the base of the first metacarpal and the distal trapezium; interposition of a proximally based joint capsule flap; and reefing of periosteal flaps elevated from the first metacarpal and including the abductor pollicis longus tendon. This procedure utilizes capsular tissue as an interposition without ligament reconstruction, eliminating the need for tendon harvest and the morbidity associated with the harvest. The postoperative rehabilitation is simple and can be done at home. An illustrative case is presented.
Level V.
拇指腕掌（基底）关节骨关节炎是手和上肢外科医生面临的一个非常常见的问题。已经描述了许多手术方法，结果各不相同。我们介绍资深作者在过去10年中使用的手术技术——带关节囊置入的部分大多角骨切除术。该手术的基本步骤是：第一掌骨基部和远侧大多角骨的骨质切除；近端带蒂关节囊瓣的置入；以及从第一掌骨掀起并包括拇长展肌腱的骨膜瓣的折叠缝合。该手术利用关节囊组织作为置入物，无需韧带重建，无需取腱以及避免了取腱相关的并发症。术后康复简单，可以在家中进行。现展示一个病例。
V级。
