Department of Plastic and Reconstructive Surgery, Johns Hopkins School of Medicine, Baltimore, MD.
Department of Plastic and Reconstructive Surgery, Johns Hopkins School of Medicine, Baltimore, MD.
J Hand Surg Am. 2024 Jun;49(6):592-601. doi: 10.1016/j.jhsa.2023.12.015. Epub 2024 Feb 7.
Painful arthritis of the small joints of the hand is a common condition affecting older adults, with distal interphalangeal joint and thumb carpometacarpal joint being the two most common locations. Younger adults may also develop painful arthritis after trauma and with inflammatory arthropathy. Traditional surgical approaches address the structure of the joints with either arthrodesis or arthroplasty with or without an implant. In recent decades, denervation has been reported as an alternative treatment for painful small joints that are mobile and stable. Publications on denervation often report faster surgery and recovery times than traditional surgeries that manipulate the small joint bony structures. This article reviews the history, anatomy, surgical techniques, and outcomes of denervation of the small joints of the hand.
手部小关节的疼痛性关节炎是一种常见的老年病，其中远节指间关节和拇指腕掌关节是最常见的两个部位。年轻人也可能因创伤和炎症性关节炎而发展为疼痛性关节炎。传统的手术方法通过关节融合或关节置换术来处理关节结构，其中包括或不包括植入物。近几十年来，神经切断术已被报道为一种治疗活动性和稳定性小关节疼痛的替代方法。关于神经切断术的出版物经常报告说，与处理小关节骨结构的传统手术相比，手术和恢复时间更快。本文回顾了手部小关节神经切断术的历史、解剖、手术技术和结果。
