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改良伊顿-利特勒重建术治疗创伤性拇指腕掌关节不稳定:手术技术与临床疗效

Modified Eaton-Littler's Reconstruction for Traumatic Thumb Carpometacarpal Joint Instability: Operative Technique and Clinical Outcomes.

作者信息

Iyengar Karthikeyan P, Matar Hosam E, Loh William Y C

机构信息

Department of Trauma and Orthopaedics, Southport and Ormskirk Hospital NHS Trust, Southport, United Kingdom.

出版信息

J Wrist Surg. 2018 Jul;7(3):191-198. doi: 10.1055/s-0037-1607423. Epub 2017 Nov 9.

Abstract

Injuries to thumb carpometacarpal joint ligaments lead to instability. Eaton-Littler's ligament reconstruction traditionally uses a strip of flexor carpi radialis to stabilize the CMC joint.  We have modified this technique to reproduce the direction of active action of the anterior oblique ligament by reconstructing both the volar and dorsoradial ligaments. In this prospective study, we evaluated patients with confirmed traumatic thumb CMC joint instability who underwent modified Eaton-Littler's reconstruction. Strength analysis, Michigan Hand Outcome Questionnaire, QuickDASH, and subjective outcome measures were collected pre- and postoperatively with minimum 3 years of follow-up. Eleven patients were included in the final analysis, with mean age of 29 years (range: 16-52) and average follow-up of 6.2 years (range: 3-11). There was a statistically significant improvement in all outcome measures.  Our modified technique helps to simultaneously address both volar and dorsal ligaments and yields satisfactory clinical outcomes at medium term follow-up.  Level IV, case series.

摘要

拇指腕掌关节韧带损伤会导致关节不稳定。传统上,伊顿-利特勒韧带重建术使用一条桡侧腕屈肌来稳定腕掌关节。我们改进了这项技术,通过重建掌侧和背桡侧韧带,重现前斜韧带的主动作用方向。在这项前瞻性研究中,我们评估了确诊为创伤性拇指腕掌关节不稳定且接受了改良伊顿-利特勒重建术的患者。在术前和术后收集了力量分析、密歇根手部结果问卷、QuickDASH以及主观结果指标,随访时间至少为3年。最终分析纳入了11名患者,平均年龄为29岁(范围:16 - 52岁),平均随访时间为6.2年(范围:3 - 11年)。所有结果指标均有统计学上的显著改善。我们的改良技术有助于同时处理掌侧和背侧韧带,在中期随访时产生令人满意的临床结果。四级病例系列。

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