| 单根肌腱多韧带重建治疗急性第一腕掌关节脱位 |
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Received:July 07, 2013
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| 作者 | Author | 单位 | Unit | E-Mail |
| 张煜 |
ZHANG Yu |
南京医科大学第一附属医院骨科, 江苏 南京 210029 |
Department of Orthopaedics, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu, China |
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| 范卫民 |
FAN Wei-min |
南京医科大学第一附属医院骨科, 江苏 南京 210029 |
Department of Orthopaedics, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu, China |
fanweimin@vip.sina.com.cn |
| 徐南伟 |
XU Nan-wei |
南京医科大学附属常州市第二人民医院骨科, 江苏 常州 213003 |
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| 顾卫东 |
GU Wei-dong |
南京医科大学附属常州市第二人民医院骨科, 江苏 常州 213003 |
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| 期刊信息：《中国骨伤》2013年26卷，第12期，第1037-1040页 |
| DOI：10.3969/j.issn.1003-0034.2013.12.016 |
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目的：探讨桡侧腕长伸肌腱重建第一腕掌关节周围4束韧带治疗急性第一腕掌关节脱位的临床疗效.
方法：自2008年12月至2012年10月，对4例急性第一腕掌关节脱位的患者切开复位后采用单根桡侧腕长伸肌重建关节周围4组韧带，即背侧韧带，掌侧韧带，桡背侧韧带，第一、二掌骨间韧带；其中男3例，女1例；平均年龄38.7岁（22～63岁）.术后根据X线片、JAMAR握力测试、拇指关节活动范围（range of motion，ROM）、活动时疼痛视觉模拟评分（visual analogue scale，VAS）等指标评价手术效果.
结果：所有患者获随访，时间6～40个月，平均19个月.术后伤口均Ⅰ级愈合.术后1、3、6个月X线片未见第一腕掌关节脱位复发，关节间隙无明显狭窄退变.JAMAR握力测试患侧恢复至健侧的60%～90%.ROM测定3例屈伸、收展活动恢复正常，1例内收受限.拇指活动时疼痛VAS评分0～1分.
结论：对于急性第一腕掌关节脱位，桡侧腕长伸肌腱重建关节周围韧带可恢复关节稳定性，改善功能. |
| [关键词]:修复外科手术 韧带 腕关节 脱位 |
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| Multi-ligaments reconstruction with single tendon with for the treatment of acute joint dislocation of the first carpometacarpal |
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Abstract:
Objective: To explore the clinical outcomes of multi-ligaments reconstruction with single tendon in treating acute joint dislocation of the first carpometacarpal.
Methods: From December 2008 to October 2012,4 patients with acute dislocation of the first carpometacarpal were treated with single carpi radialis longus tendon to reconstruct periarticular four ligaments,which included dorsal ligament,palmar ligament,dorsal radiocarpal ligament,and intermetacarpal ligament between the first and second. There were 3 males and 1 female aged from 22 to 63 years old with an average of 38.7. X-ray,JAMAR grid strength testing,range of motion of carpometacarpal joint and VAS score were used to evaluate clinical outcomes.
Results: All patients were followed up from 6 to 40 months with an average of 19 months. The wound were healed well at stageⅠ.No dislocation of the first carpometacarpal joint and signs of joints degeneration occurred on X-ray at 1,3 and 6 months after operation. JAMAR grip strength recovered from 60 percent to 90 percent of health wide. The results of ROM showed 3 cases recovered flexion and extension of joints and 1 case limited adduction. VAS score was 0 to 1.
Conclusion: For acute dislocation of the first carpometacarpal joint,reconstruction four ligaments with single carpi radialis longus tendon can be considered the selected treatment,which can restores joint stability and improve joint function. |
| KEYWORDS:Reconstructive surgical procedures Ligaments Carpal joint Dislocation |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 张煜,范卫民,徐南伟,顾卫东.单根肌腱多韧带重建治疗急性第一腕掌关节脱位[J].中国骨伤,2013,26(12):1037~1040 |
| 英文格式: | ZHANG Yu,FAN Wei-min,XU Nan-wei,GU Wei-dong.Multi-ligaments reconstruction with single tendon with for the treatment of acute joint dislocation of the first carpometacarpal[J].zhongguo gu shang / China J Orthop Trauma ,2013,26(12):1037~1040 |
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