Inoue G, Tamura Y
Department of Orthopaedic Surgery, Division of Hand Surgery, Nagoya University Branch Hospital, Japan.
J Hand Surg Am. 1996 May;21(3):464-9. doi: 10.1016/S0363-5023(96)80364-9.
Twenty-seven patients who had received treatment for dislocation of the extensor tendons over the metacarpophalangeal joint were reviewed. Sixteen patients had traumatic dislocations, seven had spontaneous dislocations, and four had congenital dislocations. The long finger was most frequently affected. The other fingers were affected almost equally. Displacement of the extensor tendon always occurred in the ulnar direction in the long and ring fingers. The index and little fingers exhibited different patterns of dislocation: two patients had ulnar dislocation of both the common and proprius tendons, and the remaining five patients had divergent dislocation of the two tendons. Nonsurgical treatment was undertaken in six cases. Surgery was performed in 21 cases. No recurrent dislocations were reported in any of the patients. Based on our experience, patients seen within 2 weeks of injury initially should be treated with splinting of the involved metacarpophalangeal joint. Chronic dislocations should be treated with a primary repair of the defect in the sagittal band. When the sagittal band is absent or deficient, the tendon must be stabilized using a loop procedure with a tendon slip.
对27例掌指关节伸肌腱脱位接受治疗的患者进行了回顾性研究。16例为创伤性脱位，7例为自发性脱位，4例为先天性脱位。示指最常受累。其他手指受累情况几乎相同。示指和环指伸肌腱的移位总是向尺侧方向。食指和小指表现出不同的脱位模式：2例患者的指总伸肌腱和指固有伸肌腱均向尺侧脱位，其余5例患者的两条肌腱呈分离性脱位。6例采用非手术治疗。21例进行了手术治疗。所有患者均未报告复发性脱位。根据我们的经验，受伤后2周内就诊的患者最初应采用受累掌指关节夹板固定治疗。陈旧性脱位应采用矢状束缺损的一期修复治疗。当矢状束缺失或不足时，必须使用肌腱束环扎术稳定肌腱。
