An Tonya W, Sun Michael, Shin Steven S
Department of Orthopaedic Surgery, Cedars-Sinai Health System, Los Angeles, CA.
Tech Hand Up Extrem Surg. 2022 Dec 1;26(4):263-266. doi: 10.1097/BTH.0000000000000396.
Basal joint arthritis is commonly associated with attenuation of the volar structures at the thumb metacarpophalangeal (MCP) joint, leading to an initially dynamic, and eventually passive hyperextension deformity. In surgical treatment of basilar thumb disease, intervention at the MCP joint should also be considered to correct deformity and prevent persistent dysfunction. We present a novel technique using suture tape augmentation of the thumb MCP joint volar plate advancement and capsulodesis, with the goal of preventing recurrent instability as a result of tissue attenuation and enabling early functional recovery. We also report a representative case of a 66-year-old woman with symptomatic thumb carpometacarpal osteoarthritis and 50 degrees of MCP passive hyperextension. She underwent trapeziectomy and MCP joint volar plate advancement and capsulodesis with suture tape augmentation. Postoperatively, the patient underwent early mobilization of the affected thumb and at final follow-up of 2 years postsurgery had a painless thumb with full opposition and without hyperextension at the MCP joint during pinch maneuvers.
拇指掌指关节（MCP）掌侧结构的减弱通常与基底关节关节炎相关，导致最初的动态，最终的被动性过伸畸形。在基底拇指疾病的手术治疗中，也应考虑对MCP关节进行干预，以纠正畸形并防止持续性功能障碍。我们提出了一种新技术，即使用缝线带增强拇指MCP关节掌板推进和关节囊固定术，目的是防止因组织减弱而导致的复发性不稳定，并实现早期功能恢复。我们还报告了一例具有代表性的病例，一名66岁女性患有症状性拇指腕掌关节骨关节炎，MCP被动过伸50度。她接受了大多角骨切除术以及MCP关节掌板推进和缝线带增强关节囊固定术。术后，患者对患侧拇指进行了早期活动，在术后2年的最终随访中，拇指无痛，可完全对掌，捏物时MCP关节无过伸。
