Cates Robert A, Brault Jeffrey S, Kakar Sanjeev
Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.
Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota.
J Wrist Surg. 2018 Apr;7(2):156-159. doi: 10.1055/s-0037-1604396. Epub 2017 Jul 24.
We report the use of botulinum toxin to aid in the treatment of chronic radial collateral ligament insufficiency of the thumb. Treatment included autograft tendon reconstruction and cast immobilization. Six weeks postoperatively, prior to hand therapy, the patient underwent an ultrasound-guided botulinum neurotoxin A injection into the adductor pollicis muscle to negate its deforming forces on the reconstruction. The patient made an excellent recovery and 1 year postoperatively was pain free and had a stable radial collateral ligament (RCL) upon examination. The outcomes of RCL repair and reconstruction are unpredictable, in part, due to the strong opposing forces of the adductor pollicis. The use of Botox injection may enhance the outcomes of RCL repair or reconstruction by neutralizing the deforming forces of the adductor muscle.
我们报告了使用肉毒杆菌毒素辅助治疗拇指桡侧副韧带慢性损伤的情况。治疗方法包括自体肌腱重建和石膏固定。术后六周，在进行手部治疗之前，患者接受了超声引导下向拇收肌注射A型肉毒杆菌神经毒素，以消除其对重建部位的变形力。患者恢复良好，术后1年无痛，检查时桡侧副韧带（RCL）稳定。RCL修复和重建的结果不可预测，部分原因是拇收肌的强大对抗力。肉毒杆菌毒素注射的使用可能通过中和内收肌的变形力来提高RCL修复或重建的效果。
