Department of Orthopaedic and Plastic Surgery, Wright State University Boonshoft School of Medicine, Dayton, Ohio.
Wright State University Boonshoft School of Medicine, Dayton, Ohio.
JBJS Case Connect. 2021 Mar 25;11(1):01709767-202103000-00062. doi: e20.00478.
A 20-year-old woman presented with painful, snapping extensor pollicis longus (EPL) tendon subluxation and trapeziometacarpal (TMC) joint instability. Hemi-extensor carpi radialis longus (ECRL) tendon autograft stabilized the TMC joint, reconstructing the 1-2 intermetacarpal ligament. The subluxed EPL tendon was centralized over the dorsal first metacarpal by tightening the metacarpophalangeal radial sagittal band and creating a dorsal first metacarpal "neosheath" pulley using ECRL graft remnant. Postoperative rehabilitation included Spica bracing and immediate thumb interphalangeal joint exercises.
The patient's pain due to EPL tendon subluxation and TMC joint instability completely resolved. Postoperative thumb range of motion and function were equivalent to the nonaffected side.
一名 20 岁女性出现疼痛、弹响的伸拇长肌腱（EPL）肌腱脱位和腕掌（TMC）关节不稳定。半腱肌桡侧伸肌（ECRL）肌腱自体移植物稳定 TMC 关节，重建 1-2 掌骨间韧带。通过拉紧掌指关节桡侧矢状带并使用 ECRL 移植物残端在背侧第一掌骨上创建“新鞘”滑车，将脱位的 EPL 肌腱集中在背侧第一掌骨上。术后康复包括 Spica 支具和立即进行拇指指间关节运动。
患者因 EPL 肌腱脱位和 TMC 关节不稳定引起的疼痛完全缓解。术后拇指活动度和功能与未受影响侧相同。
