Zhang X, Shao X, Huang W, Zhu H, Yu Y
The Second Hospital of Qinhuangdao, Changli, Qinhuangdao, Hebei, 066600, China.
Third Hospital of Hebei Medical University, Shijizhuang, Hebei, 050051, China.
Bone Joint J. 2015 Nov;97-B(11):1533-8. doi: 10.1302/0301-620X.97B11.35482.
We report a new surgical technique for the treatment of traumatic dislocation of the carpometacarpal (CMC) joint of the thumb. This is a tenodesis which uses part of the flexor carpi radialis. Between January 2010 and August 2013, 13 patients with traumatic instability of the CMC joint of the thumb were treated using this technique. The mean time interval between injury and ligament reconstruction was 13 days (0 to 42). The mean age of the patients at surgery was 38 years: all were male. At a mean final follow-up of 26 months (24 to 29), no patient experienced any residual instability. The mean total palmar abduction of the CMC joint of the thumb was 61° and the mean radial abduction 65° The mean measurements for the uninjured hand were 66° (60° to 73°) and 68° (60° to 75°), respectively. The mean Kapandji thumb opposition score was 8.5° (8° to 9°). The mean pinch and grip strengths of the hand were 6.7 kg (3.4 to 8.2) and 40 kg (25 to 49), respectively. The mean Disabilities of the Arm, Shoulder, and Hand questionnaire score was 3 (1 to 6). Based on the Smith and Cooney score, we obtained a mean score of 85 (75 to 95), which included four excellent, seven good, and two fair results. Our technique offers an alternative method of treating traumatic dislocation of the CMC joint of the thumb: it produces a stable joint and acceptable hand function.
我们报告了一种治疗拇指腕掌（CMC）关节创伤性脱位的新手术技术。这是一种采用部分桡侧腕屈肌的腱固定术。在2010年1月至2013年8月期间，13例拇指CMC关节创伤性不稳定患者采用该技术进行治疗。受伤与韧带重建之间的平均时间间隔为13天（0至42天）。手术时患者的平均年龄为38岁：均为男性。平均末次随访26个月（24至29个月）时，无患者出现任何残留不稳定情况。拇指CMC关节的平均总掌侧外展为61°，平均桡侧外展为65°。未受伤手的平均测量值分别为66°（60°至73°）和68°（60°至75°）。平均Kapandji拇指对掌评分8.5°（8°至9°）。手的平均捏力和握力分别为6.7 kg（3.4至8.2 kg）和40 kg（25至49 kg）。手臂、肩部和手部功能障碍问卷的平均评分为3分（1至6分）。根据Smith和Cooney评分，我们获得的平均评分为85分（75至95分），其中包括4个优、7个良和2个可的结果。我们的技术为治疗拇指CMC关节创伤性脱位提供了一种替代方法：它能产生稳定的关节和可接受的手部功能。
