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拇指掌指关节过伸畸形的管理:伴有拇指掌指关节骨关节炎。

Management of Thumb Metacarpophalangeal Hyperextension in the Setting of Thumb Basal Joint Arthritis.

机构信息

From the Department of Orthopedics and Rehabilitation, University of New Mexico, Albuquerque, NM (Morrell), Hand & Microsurgery, Plastic Surgery, Shannon Medical Center, San Angelo, TX (Menon), and the Hospital for Special Surgery, Weill Cornell Medical College, New York City, NY (Nolan).

出版信息

J Am Acad Orthop Surg. 2022 Aug 1;30(15):703-710. doi: 10.5435/JAAOS-D-21-00981. Epub 2022 Apr 25.

Abstract

Thumb metacarpophalangeal (MCP) joint hyperextension is a well-established sequela of advanced carpometacarpal (CMC) joint arthritis. This deformity results in poor patient function because the ability to perform key pinch is negatively affected. For this reason, surgeons must consider the presence of an MCP deformity when addressing CMC arthritis. A variety of nonsurgical and surgical interventions have emerged. Surgical treatments can be grouped into four main categories: (1) volar plate advancement/capsulodesis, (2) tendon transfer and tenodesis, (3) sesamoidesis, and (4) arthrodesis. Surgical intervention is based on both the degree of deformity present and the surgeon preference. This review aims to clarify indications for various treatments of MCP joint hyperextension, outline commonly performed procedures, and report the published outcomes and potential complications of these interventions.

摘要

拇指掌指(MCP)关节过伸是晚期腕掌(CMC)关节关节炎的一种公认后遗症。这种畸形会导致患者功能不佳,因为关键捏合能力受到负面影响。出于这个原因,当处理 CMC 关节炎时,外科医生必须考虑 MCP 畸形的存在。已经出现了各种非手术和手术干预措施。手术治疗可分为四大类:(1)掌板推进/囊切开术,(2)肌腱转移和肌腱固定术,(3)籽骨固定术,以及(4)关节融合术。手术干预的依据是畸形的严重程度和外科医生的偏好。本综述旨在阐明 MCP 关节过伸各种治疗方法的适应证,概述常见的手术操作,并报告这些干预措施的已发表结果和潜在并发症。

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