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月骨脱位伴拇长屈肌撕脱及拇指侧副韧带损伤:一例报告

Lunate Dislocation with Flexor Pollicis Longus Avulsion, and Thumb Collateral Ligament Injury: A Case Report.

作者信息

Louka Jean G, Zeine Georges, Pourre Damien

机构信息

Department of Orthopaedics and Traumatology, Simone Veil Hospital, Eaubonne, France.

出版信息

J Orthop Case Rep. 2022 Feb;12(2):101-105. doi: 10.13107/jocr.2022.v12.i02.2686.

Abstract

INTRODUCTION

Lunate dislocation is a rare and devastating injury of the wrist that requires prompt management and surgical repair. The association of this lesion with a flexor pollicis longus (FPL) injury and a Stener lesion appears to be extremely uncommon.

CASE REPORT

We present the case of a 31-year-old man who was riding his motorbike when he was struck by a car, resulting in a volar dislocation of the lunate, a concomitant fracture of the second phalanx of the thumb, a FPL avulsion, and a thumb ulnar collateral ligament (UCL) injury. While there are numerous articles about associated lunate and other carpal and wrist injuries, a combination of lunate dislocation with the above-mentioned injuries is exceptionally rare. After conducting a literature review, the clinical case was detailed and discussed. The injuries were managed with open reduction, internal fixation of the lunate dislocation, primary direct repair of the scapholunate ligament and thumb UCL tears utilizing suture anchor fixation, and surgical reinsertion of the FPL tendon.

CONCLUSION

In the face of the atypical presentation, we stress the importance of carefully assessing the lesion and searching for any associated injuries both clinically and radiologically, particularly if a comprehensive evaluation was not possible.

摘要

引言

月骨脱位是一种罕见且严重的腕部损伤,需要及时处理和手术修复。这种损伤与拇长屈肌(FPL)损伤及斯滕纳(Stener)损伤同时存在的情况似乎极为罕见。

病例报告

我们报告一例31岁男性病例,该患者骑摩托车时被汽车撞击,导致月骨掌侧脱位,同时伴有拇指近节指骨骨折、拇长屈肌撕脱伤以及拇指尺侧副韧带(UCL)损伤。虽然有许多关于月骨及其他腕骨和腕部损伤相关的文章,但月骨脱位合并上述损伤的情况极为罕见。在进行文献回顾后,详细阐述并讨论了该临床病例。损伤的处理方式为切开复位、月骨脱位内固定、使用缝线锚钉固定对舟月韧带和拇指尺侧副韧带撕裂进行一期直接修复,以及拇长屈肌腱的手术再植入。

结论

面对这种非典型表现,我们强调仔细评估损伤并在临床和影像学上查找任何相关损伤的重要性,尤其是在无法进行全面评估的情况下。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d077/9499161/f0bf7d288b7b/JOCR-12-101-g001.jpg

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