Graham Jack G, Rivlin Michael, Abboudi Jack, Lutsky Kevin, Beredjiklian Pedro K
Department of Orthopedic Surgery, The Rothman Institute, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA.
Department of Orthopedic Surgery, The Rothman Institute, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA.
J Hand Surg Am. 2019 Apr;44(4):344.e1-344.e5. doi: 10.1016/j.jhsa.2018.04.016. Epub 2018 May 24.
Trapeziectomy with suture-button suspensionplasty is a surgical treatment option for thumb carpometacarpal osteoarthritis refractory to nonsurgical management. We describe the cases of 3 patients who presented with index metacarpal fracture, in the absence of traumatic injury, over 4 months after trapeziectomy with suture-button suspensionplasty. All 3 fractures demonstrated the same pattern: short oblique/spiral, oriented proximal radial to distal ulnar with the distal end in the vicinity of the index metacarpal button, presumably after the orientation of the metacarpal drill hole. Two of the fractures were treated with surgical fixation. Fracture healing was obtained in all cases. Two of the 3 patients remained symptomatic with thumb pain, but decided against revision treatment for the carpometacarpal osteoarthritis. The third underwent restabilization of the suture button at the time of fracture fixation. Although uncommon, index metacarpal fracture after trapeziectomy with suture-button suspensionplasty can present without trauma several months after surgery.
带缝线纽扣悬吊成形术的大多角骨切除术是治疗非手术治疗无效的拇指腕掌关节骨关节炎的一种手术选择。我们描述了3例患者的病例，他们在接受带缝线纽扣悬吊成形术的大多角骨切除术后4个多月，在没有创伤的情况下出现了示指掌骨骨折。所有3例骨折表现出相同的模式：短斜形/螺旋形，从近端桡侧向远端尺侧，远端位于示指掌骨纽扣附近，推测是按照掌骨钻孔的方向。其中2例骨折接受了手术固定。所有病例均获得骨折愈合。3例患者中有2例仍有拇指疼痛症状，但决定不接受腕掌关节骨关节炎的翻修治疗。第3例患者在骨折固定时对缝线纽扣进行了重新固定。虽然不常见，但带缝线纽扣悬吊成形术的大多角骨切除术后示指掌骨骨折可在术后数月无创伤的情况下出现。
