Takami H, Takahashi S, Ando M
Section of Orthopaedic Surgery, Kanto Rosai Hospital, Kawasaki, Japan.
Arch Orthop Trauma Surg. 1998;118(1-2):21-4. doi: 10.1007/s004020050303.
In the pathology of simple complete dislocation involving the metacarpophalangeal joint of the thumb, whether or not the palmar plate is interposed within the joint is controversial. Nine cases of complete dorsal dislocation of the joint were reviewed, and cadaver dissection was performed to study the pathology of this injury. Eight of the nine patients were seen within 4 days of injury and treated successfully by closed manipulation. One patient treated 7 days after the injury required open reduction. We were able to reproduce the pathological anatomy of the dislocation, wedging of the palmar plate in the joint of the cadaver. In this cadaver and in all clinical cases, radiographs showed a complete dislocation with an increased distance between the palmar edge of the base of the proximal phalanx and the metacarpal head, indicating an interposition of the palmar plate. Our study suggests that in simple complete dislocations of this joint, the palmar plate is interposed between the displaced bones.
在单纯累及拇指掌指关节的完全脱位的病理学中，掌板是否嵌入关节内存在争议。回顾了9例该关节完全背侧脱位的病例，并进行尸体解剖以研究这种损伤的病理学。9例患者中有8例在受伤后4天内就诊，通过闭合手法复位成功治疗。1例在受伤7天后接受治疗的患者需要切开复位。我们能够重现脱位的病理解剖结构，即尸体关节中掌板的楔入。在这具尸体以及所有临床病例中，X线片显示完全脱位，近端指骨基底掌侧边缘与掌骨头之间的距离增加，提示掌板嵌入。我们的研究表明，在该关节的单纯完全脱位中，掌板夹在移位的骨头之间。
