Kiefhaber T R, Strickland J W
Indiana Hand Center, Indianapolis.
J Hand Surg Am. 1993 Nov;18(6):984-9. doi: 10.1016/0363-5023(93)90387-I.
Ninety-two fingers with rheumatoid swan-neck deformity were treated with dorsal capsulotomy and lateral band mobilization. An initial increase of 55 degrees of motion into flexion was noted, but this proximal interphalangeal motion deteriorated over time. Of 15 fingers followed at 3 and 12 months, there was a mean loss of 17 degrees of the early postoperative flexion. Nineteen fingers with rheumatoid boutonniere deformity were treated with central slip reconstruction. The results were unpredictable, with only modest improvement in the proximal interphalangeal extension, which deteriorated over time. The authors now recommend arthrodesis for most severe rheumatoid boutonniere deformities.
对92例患有类风湿性天鹅颈畸形的手指进行了背侧关节囊切开术和外侧束活动术治疗。最初观察到屈曲活动度增加了55度，但随着时间推移，这种近端指间关节活动度恶化。在15例随访3个月和12个月的手指中，术后早期屈曲平均丧失了17度。对19例患有类风湿性纽扣花样畸形的手指进行了中央束重建治疗。结果不可预测，近端指间关节伸展仅略有改善，且随着时间推移而恶化。作者现在建议对大多数严重的类风湿性纽扣花样畸形进行关节融合术。
