拇指籽骨翻转脱位致掌指关节绞锁的诊治
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王西迅 WANG Xi- xun 中国武装警察部队浙江省总队医院手足外科,浙江 嘉兴 314000 Department of Hand and Foot Surgery,Zhejiang Provincial Corps Hospital of Chinese Peoples Armed Police Forces,Jiaxing 314000,Zhejiang,China xixunwang@163.com 
李钧 LI Jun 中国武装警察部队浙江省总队医院手足外科,浙江 嘉兴 314000 Department of Hand and Foot Surgery,Zhejiang Provincial Corps Hospital of Chinese Peoples Armed Police Forces,Jiaxing 314000,Zhejiang,China  
童哲 TONG Zhe 中国武装警察部队浙江省总队医院手足外科,浙江 嘉兴 314000 Department of Hand and Foot Surgery,Zhejiang Provincial Corps Hospital of Chinese Peoples Armed Police Forces,Jiaxing 314000,Zhejiang,China  
孙文海 SUN Wen-hai 山东省立医院手足外科  
陈波 CHEN Bo 中国武装警察部队浙江省总队医院手足外科,浙江 嘉兴 314000 Department of Hand and Foot Surgery,Zhejiang Provincial Corps Hospital of Chinese Peoples Armed Police Forces,Jiaxing 314000,Zhejiang,China  
胡继超 HU Ji-chao 中国武装警察部队浙江省总队医院手足外科,浙江 嘉兴 314000 Department of Hand and Foot Surgery,Zhejiang Provincial Corps Hospital of Chinese Peoples Armed Police Forces,Jiaxing 314000,Zhejiang,China  
崔岩 CUI-Yan 中国武装警察部队浙江省总队医院手足外科,浙江 嘉兴 314000 Department of Hand and Foot Surgery,Zhejiang Provincial Corps Hospital of Chinese Peoples Armed Police Forces,Jiaxing 314000,Zhejiang,China  
魏勇 WEI-Yong 中国武装警察部队浙江省总队医院手足外科,浙江 嘉兴 314000 Department of Hand and Foot Surgery,Zhejiang Provincial Corps Hospital of Chinese Peoples Armed Police Forces,Jiaxing 314000,Zhejiang,China  
潘跃 PAN-Yue 中国武装警察部队浙江省总队医院手足外科,浙江 嘉兴 314000 Department of Hand and Foot Surgery,Zhejiang Provincial Corps Hospital of Chinese Peoples Armed Police Forces,Jiaxing 314000,Zhejiang,China  
期刊信息:《中国骨伤》2009年,第22卷,第4期,第263-264页
DOI:doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz
基金项目:
中文摘要:

目的:探讨拇指籽骨翻转脱位致掌指关节绞锁的诊断和治疗。

方法:对5例掌指关节绞锁患者(男4例,女1例;年龄18~47岁,平均35岁)行闭合手法复位,成功3例,另2例闭合复位失败后行手术切开复位。术中见拇指籽骨翻转脱位,与掌板、拇短屈肌腱一起卡入掌指关节间隙的掌侧,形成绞锁。籽骨复位后,绞锁即得到纠正。

结果:5例均获得随访,时间3~34个月,平均15个月。治疗后所有患者局部疼痛症状消失,无红肿,手指感觉正常,掌指关节屈曲35°~60°,平均45°,不影响正常生活及正常工作,治疗后绞锁无复发。

结论:拇指籽骨翻转脱位是导致掌指关节绞锁的重要原因之一。
【关键词】拇指  籽骨  掌指关节  外科手术
 
Diagnosis and treatment of the metacarpophalangeal joint locking caused by sesamoid turned-over dislocation of the thumb
ABSTRACT  

Objective: To introduce diagnosis and treatment of the metacarpophalangeal joint(MPJ) locking caused by sesamoid turned-over dislocation of the thumb.

Methods: Five cases with metacarpophalangeal joint locking were involved in the study,male 4 and female 1. The average age was 35 years old(ranging from 18 to 47 years). All the patients received manual reduction under local anaesthesia. But only three were successful,others patients were reduced by operation. Metacarpophalangeal joint locking caused by sesamoid turned-over dislocation with the volar plate and the short flexor muscle of the thumb tendon were reveded. The metacarpophalangeal joint locking was released after reduction of sesamoid turned-over dislocation of the thumb.

Results: The mean follow-up time was 15 months (3-34 months). The mean range of MPJ flexion was 45°(35°-60°). The signs for pain and swelling were released. Satisfactory thumb opposition can be seen.

Conclusion: It was one of the important reasons of the metacarpophalangeal joint locking caused by sesamoid turned-over dislocation of the thumb.
KEY WORDS  Thumb  Sesamoid bones  Metacarpophalangeal joint  Surgical procedures,operative
 
引用本文,请按以下格式著录参考文献:
中文格式:王西迅,李钧,童哲,孙文海,陈波,胡继超,崔岩,魏勇,潘跃.拇指籽骨翻转脱位致掌指关节绞锁的诊治[J].中国骨伤,2009,22(4):263~264
英文格式:WANG Xi- xun,LI Jun,TONG Zhe,SUN Wen-hai,CHEN Bo,HU Ji-chao,CUI-Yan,WEI-Yong,PAN-Yue.Diagnosis and treatment of the metacarpophalangeal joint locking caused by sesamoid turned-over dislocation of the thumb[J].zhongguo gu shang / China J Orthop Trauma ,2009,22(4):263~264
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