Endress Ryan D, Kakar Sanjeev
Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN.
Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN.
J Hand Surg Am. 2014 Dec;39(12):2512-6. doi: 10.1016/j.jhsa.2014.09.012. Epub 2014 Oct 28.
Several surgical options exist for the treatment of basilar thumb joint arthritis. Suspending the thumb metacarpal with a suture button device provides a stabilizing force to maintain pinch strength, precludes the necessary healing time associated with ligamentous reconstruction and allows for earlier motion and return to work, and creates a stable construct that may prevent metacarpal subsidence over time. One of the concerns with this technique is over-tightening of the suture device, which results with impingement of the thumb and index metacarpal bases. We present a surgical technique of open trapeziectomy, simultaneous application of 2 Mini TightRope button devices to provide additional stabilization that prevents impingement of the thumb and index finger metacarpal, with imbrication of the flexor carpi radialis and abductor pollicis longus tendons as reinforcement of the construct.
治疗基底拇指关节关节炎有多种手术选择。使用缝线纽扣装置悬吊拇指掌骨可提供稳定力以维持捏力，避免了与韧带重建相关的必要愈合时间，并允许更早活动和恢复工作，还能创建一个稳定结构，可能防止掌骨随时间沉降。该技术的一个问题是缝线装置过度收紧，这会导致拇指和示指掌骨基底撞击。我们介绍一种开放性大多角骨切除术的手术技术，同时应用2个Mini TightRope纽扣装置以提供额外稳定，防止拇指和示指掌骨撞击，并重叠缝合桡侧腕屈肌腱和拇长展肌腱以加强该结构。
