Department of Hand Surgery, Schulthess Klinik, Lengghalde 2, Zurich 8008, Switzerland.
Hand Clin. 2025 Feb;41(1):93-102. doi: 10.1016/j.hcl.2024.08.003. Epub 2024 Oct 16.
Deformities of the thumb in the context of rheumatoid arthritis are not uncommon and lead to early functional limitations due to the great importance of the first ray in almost all gripping functions. The various deformities of the thumb were already classified by Nalebuff in 1968, and this classification is still valid today. The treatment of a thumb deformity depends on the functional limitations, the number of affected joints, and the patient's requirements. In addition to tendon reconstructions, arthrodesis and arthroplasty are used. The decision is made individually depending on the status of the neighboring joints and the disease activity.
类风湿关节炎患者的拇指畸形并不少见,由于第一掌骨在几乎所有抓握功能中都具有重要意义,因此这些畸形会导致早期的功能受限。早在 1968 年,Nalebuff 就已经对拇指畸形进行了分类,而这一分级至今仍然适用。拇指畸形的治疗取决于功能受限程度、受累关节数量和患者的要求。除了肌腱重建外,还可采用关节融合术和关节成形术。具体的治疗方案取决于相邻关节的状态和疾病活动度,需要进行个体化决策。