Kim Jennifer S, Hussain Kumail, Higginbotham Devan O, Tsai Andrew G
Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL, 60064, USA.
Department of Orthopaedic Surgery, Detroit Medical Center, Detroit, MI, 48201, USA.
J Orthop. 2021 Apr 1;25:59-63. doi: 10.1016/j.jor.2021.03.015. eCollection 2021 May-Jun.
Although rare, thumb Carpometacarpal (CMC) joint dislocations can have significant complications which impact hand function. Optimal management is crucial in restoring pinch and grasp strength, but no agreement exists regarding treatment due to a paucity of literature on this subject. Systematic review was conducted involving non-operative and operative management of the CMC joint. 15 articles with a total of 60 thumbs were evaluated from published literature. 12/60 thumbs with isolated CMC joint dislocations were treated with closed reduction, with 4 cases needing additional ligament repair due to joint instability post-reduction. 51/60 of the isolated CMC joint dislocations had ligament reconstruction, with flexor carpi radialis tendon autograft (29/51) as the most popular option. 60/60 patients regained full function and stability of the CMC joint with significant pain relief. Although good surgical outcomes have been achieved, long term clinical outcome reporting is needed to develop a standardized approach to treatment.
虽然拇指腕掌关节(CMC)脱位很少见,但可能会出现严重影响手部功能的并发症。最佳治疗方法对于恢复捏力和握力至关重要,但由于关于该主题的文献较少,目前在治疗方面尚无共识。我们对CMC关节的非手术和手术治疗进行了系统评价。从已发表的文献中评估了15篇文章,共涉及60例拇指。60例中12例孤立性CMC关节脱位采用闭合复位治疗,其中4例因复位后关节不稳定需要额外的韧带修复。60例中51例孤立性CMC关节脱位进行了韧带重建,其中以桡侧腕屈肌腱自体移植(29/51)最为常用。60例患者的CMC关节均恢复了全部功能和稳定性,疼痛明显缓解。虽然已取得了良好的手术效果,但仍需要长期的临床结果报告来制定标准化的治疗方法。