掌、背侧韧带同时重建治疗第一腕掌关节脱位

Reconstruction of the volar and dorsal ligaments for treatment of dislocation of the first CMC joint

目的 通过对第一腕掌关节掌背侧韧带的同时重建 ,为治疗第一腕掌关节脱位提供一种新的术式。方法 利用桡侧腕屈肌腱和桡侧腕长伸肌腱桡侧部分腱束移位 ,与拇长展肌腱交叉后编织缝合 ,起到同时重建掌、背侧韧带 ,并将第一掌骨悬吊的作用 ,使脱位的第一腕掌关节复位并稳定。结果 临床应用 3例 ,效果满意。结论 桡侧屈腕肌腱和桡侧腕长伸肌腱部分移位与拇长展肌腱交叉缝合法符合第一腕掌关节韧带重建的解剖要求 ,操作简单 ,疗效满意 。

ObjectiveTo introduce a novel surgical technique to treat disl oc ation of the first carpo- metacarpal (CMC) joint. Methods3 ca ses of first CMC joint dislocation were treated with the new technique. After reduction of the di slocated CMC joint, the volar and dorsal ligaments were reconstructed by transfe r of the flexor carpi radialis (FCR) tendon and the extensor carpi radialis long us (ECRL) tendon. The radial half of FCR and ECRL tendons were taken and woven t o the abductor pollicis longus to reconstruct the ligaments and suspend the firs t metacarpal. All 3 cases were followed for more than half a year. Resul tsGood stability of the first CMC joint was observed at follow-up. Thumb opposition wa s good with powerful pinch. The patients were pain free. ConclusionThis surgica l procedure restores ligament anatomy of the first CMC joint. The treatment outc ome is satisfying. It therefore is a reliable method for treating dislocation of the first CMC joint.