Tsai Chia-Chin, Shieh Shyh-Jou
From the Division of Plastic and Reconstructive Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medicine, and.
Ann Plast Surg. 2019 Jan;82(1S Suppl 1):S130-S135. doi: 10.1097/SAP.0000000000001702.
Locked thumb metacarpophalangeal joint caused by entrapment of the sesamoid bone is an uncommon entity. The intact volar plate, strong ligamentous attachment between the sesamoid bone and the joint, and altered axis of inserted muscle all contribute to failure of closed reduction. The patient's history, clinical presentation, and plain radiographic findings are all important clues to diagnosing this rare disease. We describe 2 patients with a similar mechanism of injury, where the sesamoid bones were displaced into the thumb metacarpophalangeal joint causing lock thumb. The anatomy, pathophysiology, and surgical management of the patients are also described and discussed. Both patients were successfully treated with meticulous open reduction.
籽骨嵌顿导致的拇指掌指关节绞锁是一种罕见的病症。完整的掌板、籽骨与关节之间牢固的韧带附着以及插入肌肉的轴线改变均导致闭合复位失败。患者的病史、临床表现及X线平片表现都是诊断这种罕见疾病的重要线索。我们描述了2例具有相似损伤机制的患者，其籽骨移位至拇指掌指关节导致拇指绞锁。还对患者的解剖结构、病理生理及手术治疗进行了描述和讨论。两名患者均通过细致的切开复位获得成功治疗。
