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桡侧腕屈肌腱部分移位治疗第一掌腕关节创伤性脱位

[Partial translocation of flexor carpi radialis tendon for treatment of traumatic dislocation of first carpometacarpal joint].

作者信息

Chen Yaolin, Yang Yong, Wang Zhenzhong, Wang Yang

机构信息

Department of Orthopedics, Fuwai Central China Cardiovascular Hospital, Zhengzhou Henan, 450003, P. R. China.

Department of Hand Surgery, Beijing Jishuitan Hospital, Capital Medical University, Beijing, 100032, P. R. China.

出版信息

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2025 Jun 15;39(6):668-672. doi: 10.7507/1002-1892.202503094.

Abstract

OBJECTIVE

To explore the effectiveness of partial translocation of flexor carpi radialis tendon in the treatment of traumatic dislocation of the first carpometacarpal joint.

METHODS

The clinical data of 6 patients with traumatic dislocation of the first carpometacarpal joint who met the selection criteria between March 2020 and June 2024 were retrospectively analyzed. There were 3 males and 3 females with an average age of 33.5 years (range, 16-42 years). All the 6 cases were treated with plaster immobilization for 4-6 weeks, and the time from injury to operation was 6-12 weeks, with an average of 8.8 weeks. All patients underwent reconstruction of the metacarpophalangeal anterior oblique ligament and dorsal posterior oblique ligament of the first carpometacarpal joint with partial translocation of flexor carpi radialis tendon. The pain relief was evaluated by visual analogue scale (VAS) score before and after operation, and the pinch force, palmar abduction and radial abduction angles of the affected side and the healthy side were recorded before and after operation, and the ratio of the above indexes between the affected side and the healthy side was calculated to evaluate the effectiveness.

RESULTS

All the incisions healed by first intention after operation, and there was no complication related to operation such as neurovascular injury. All patients were followed up 6-19 months (mean, 12.7 months). The range of motion of the thumb on the affected side was the same as that on the healthy side, the first carpometacarpal joint was stable without recurrent dislocation and pain. At last follow-up, the VAS score, the pinch force of the affected side, the abduction angle of the palmar side of the affected thumb, the abduction angle of the radial side of the affected thumb, and the pinch force ratio, the palmar abduction angle ratio of the thumb, and the radial abduction angle ratio of the thumb of the affected side to the healthy side significantly improved when compared with those before operation ( <0.05).

CONCLUSION

Partial translocation of the flexor carpi radialis tendon to reconstruct the metacarpophalangeal and dorsal radial ligaments for the treatment of traumatic dislocation of the first carpometacarpal joint is a reliable surgical method.

摘要

目的

探讨桡侧腕屈肌腱部分移位治疗第一掌腕关节创伤性脱位的有效性。

方法

回顾性分析2020年3月至2024年6月间6例符合入选标准的第一掌腕关节创伤性脱位患者的临床资料。其中男性3例,女性3例,平均年龄33.5岁(范围16 - 42岁)。6例均采用石膏固定4 - 6周,受伤至手术时间为6 - 12周,平均8.8周。所有患者均采用桡侧腕屈肌腱部分移位重建第一掌腕关节掌指前斜韧带和背侧后斜韧带。通过视觉模拟量表(VAS)评分评估手术前后疼痛缓解情况,记录手术前后患侧和健侧的捏力、掌侧外展和桡侧外展角度,并计算上述指标患侧与健侧的比值以评估疗效。

结果

术后所有切口均一期愈合,未发生神经血管损伤等手术相关并发症。所有患者均获随访6 - 19个月(平均12.7个月)。患侧拇指活动范围与健侧相同,第一掌腕关节稳定,无复发性脱位及疼痛。末次随访时,与术前相比,患侧VAS评分、捏力、患侧拇指掌侧外展角度、患侧拇指桡侧外展角度以及患侧与健侧的捏力比值、拇指掌侧外展角度比值、拇指桡侧外展角度比值均显著改善(<0.05)。

结论

桡侧腕屈肌腱部分移位重建掌指及桡背侧韧带治疗第一掌腕关节创伤性脱位是一种可靠的手术方法。

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