Sim E
Unfallkrankenhaus Meidling, Wien.
Handchir Mikrochir Plast Chir. 1989 May;21(3):138-46.
This report deals with twenty-nine dislocations of the carpometacarpal joint of the thumb--twenty-five closed and four compound dislocations, three of which were part of complex injuries of the hand--treated during the period 1957 to 1983. The closed dislocations comprised eighteen dorsal, three dorsal-ulnar, two dorsal-radial, one palmar, and one palmar-ulnar. The compound dislocations comprised one radial (isolated), one palmar-radial, one dorsal-radial, and one palmar-ulnar; the last three occurring together with complex injuries. Eleven patients were followed up after an average period of about eleven years. Closed dislocations including those with minor tears of ligaments and/or the joint capsule do not require operative treatment. Reduction and immobilization for four weeks in a plaster splint with inclusion of the thumb were sufficient; recurrence of the dislocations did not occur. The compound dislocations required temporary transarticular Kirschner wire fixation as the ligament and the capsule were completely torn.
本报告涉及1957年至1983年期间治疗的29例拇指腕掌关节脱位——25例闭合性脱位和4例开放性脱位,其中3例是手部复合伤的一部分。闭合性脱位包括18例背侧脱位、3例背尺侧脱位、2例背桡侧脱位、1例掌侧脱位和1例掌尺侧脱位。开放性脱位包括1例桡侧(孤立性)脱位、1例掌桡侧脱位、1例背桡侧脱位和1例掌尺侧脱位;后3例与复合伤同时发生。11例患者在平均约11年的时间后接受了随访。包括伴有韧带和/或关节囊轻微撕裂的闭合性脱位不需要手术治疗。用包括拇指的石膏夹板复位并固定四周就足够了;脱位没有复发。由于韧带和关节囊完全撕裂,开放性脱位需要临时经关节克氏针固定。