Leemrijse T, Cadot B, Valtin B, Touam C, Oberlin C
Service de chirurgie Orthopédique et Reconstructrice, Hôpital Bichat, Paris.
Ann Chir Main Memb Super. 1996;15(3):132-7. doi: 10.1016/s0753-9053(96)80002-0.
Volar dislocation of the four long fingers is a common situation in rheumatoid hands. Surgical reduction is rather difficult because of soft tissue retraction, especially interosseous muscles, and requires large releases. The authors propose the use of Weil's osteotomy, initially described in foot surgery. This is an oblique cervico-capital osteotomy which shortens the metacarpal bone, fixed by two screws. This makes soft tissue release less extensive and facilitates relocation of the extensor tendon. Two cases are reported.
类风湿性手部中,四个长手指的掌侧脱位是一种常见情况。由于软组织回缩,尤其是骨间肌,手术复位相当困难,需要进行大范围的松解。作者建议使用最初在足部手术中描述的韦尔截骨术。这是一种斜行的颈干截骨术,可缩短掌骨,并通过两枚螺钉固定。这使得软组织松解范围减小,并便于伸肌腱的重新定位。报告了两例病例。