Filler B C, Stark H H, Boyes J H
J Bone Joint Surg Am. 1976 Jul;58(5):667-70.
A deformity of hyperextension of the metacarpophalangeal joint of the thumb occurring in thirteen children with spastic cerebral palsy was corrected by capsulodesis of the joint. The technique involves shifting the metacarpal attachment of the volar plate more proximally in the metacarpal. When combined with selective release of the involved intrinsic muscles and selective transfer of the extrinsic motors, when indicated, the thumb is brough away from the palm and its function and appearance are improved. Moreover, there is not risk to growth of the thumb such as might follow arthrodesis in a growing child. Results were satisfactory except in two athetoid patients, in whom some of the intial correction was lost, but even their thumbs did not revert into hyperextension. In five patients, for reasons not entirely clear, the previously flexed interphalangeal joint had better extension postoperatively. This improved the function of the thumb, because the broad pulp of the thumb could then be used firmly against the side of the index finger.
对13例痉挛型脑瘫患儿出现的拇指掌指关节过伸畸形，采用关节囊固定术进行了矫正。该技术包括将掌板在掌骨上的附着点向掌骨近端移位。当与受累固有肌的选择性松解及必要时外在运动肌的选择性转移相结合时，拇指可从手掌移开，其功能和外观得到改善。此外，不存在像在生长中的儿童进行关节融合术那样可能影响拇指生长的风险。除2例手足徐动型患者外，结果均令人满意，这2例患者最初的部分矫正有所丢失，但即使是他们的拇指也未恢复到过伸状态。在5例患者中，由于不完全清楚的原因，术前屈曲的指间关节术后伸直情况更好。这改善了拇指的功能，因为此时拇指宽大的指腹可以牢固地抵靠在示指侧面。
