Bull Hosp Jt Dis (2013). 2022 Jun;80(2):122-128.
A retrospective review was conducted of 500 consecutive patients who underwent surgery for complete collateral ligament ruptures of their thumb metacarpophalangeal (MP) joints comprising 362 ulnar collateral and 138 radial collateral ligaments. Complete rupture was confirmed in all cases at surgery. When surgery was carried out within 3 weeks of the injury, reinsertion of the ligament was pos- sible in 98% of cases. When surgery was performed after 3 weeks, reinsertion of the ligament was possible in 45% of ulnar and 68% of radial injuries. Reconstruction utilizing a free tendon graft was required for the other cases. All patients who had surgery within 3 weeks of their injuries regained stable, pain free thumbs. Surgery was less suc- cessful in patients who had surgery after 3 weeks and the failure rate was 5%. Surgery within 3 weeks of the injury permitted re-insertion of the ligament in almost all cases. We propose that avulsions treated within that period be referred to as "acute" injuries and those treated later as "chronic." Treatment of acute injuries is preferred because they rarely require reconstruction, and the results were better than when surgery was performed for chronic injuries. Repair of thumb MP collateral ligaments is predictably possible within 3 weeks of injury but less likely if surgery is delayed after that time period.
对 500 例拇指掌指（MP）关节完全侧副韧带断裂患者进行回顾性研究，其中包括 362 例尺侧副韧带和 138 例桡侧副韧带。所有病例均在手术中证实为完全断裂。如果在受伤后 3 周内进行手术，98%的病例可以进行韧带再插入。如果在 3 周后进行手术，45%的尺侧和 68%的桡侧损伤可以进行韧带再插入。对于其他病例，则需要使用游离肌腱移植物进行重建。所有在受伤后 3 周内接受手术的患者拇指均恢复稳定、无痛。在受伤后 3 周后接受手术的患者手术成功率较低，为 5%。在受伤后 3 周内进行手术几乎可以在所有病例中进行韧带再插入。我们提出，在此期间治疗的撕脱伤应称为“急性”损伤，而在此之后治疗的损伤应称为“慢性”损伤。我们更倾向于治疗急性损伤，因为它们很少需要重建，而且结果优于治疗慢性损伤。拇指 MP 侧副韧带的修复在受伤后 3 周内是可以预测的，但如果在此时间后延迟手术，则不太可能。
