早期手术切开复位治疗新鲜嵌顿性掌指关节脱位  

Early open reduction of acute incarceratied metacarpophalangeal dislocation

作　　者：王万宏[1] 侯春林[2] 谭晓毅[1] 王颖[1] 

机构地区：[1]宜昌市第一人民医院骨科 [2]上海长征医院骨科

出　　处：《中国骨伤》2008年第4期293-294,共2页China Journal of Orthopaedics and Traumatology

摘　　要：目的:探讨嵌顿性掌指关节脱位的致伤机制及治疗方法。方法:收治新鲜嵌顿性掌指关节脱位7例,其中男6例,女1例;年龄8～33岁,平均17岁。7例均为背侧脱位,食指3例,拇指2例,中指1例,小指1例,均为闭合复位失败予切开复位。术中均见致伤机制为"纽扣"式机制,掌骨头自关节囊掌侧薄弱部穿出,掌板嵌顿在掌骨头背侧。结果:7例随访3～42个月,均解剖复位,伸屈功能良好。结论:对嵌顿性掌指关节脱位若闭合复位失败,不应多作手法整复,应早期手术切开复位,以免导致功能障碍。Objective：To explore the mechanism and the treatment of acute incarcerated metacarpophalangeal dislocation. Methods：Seven patients（6 male and 1 female）with acute incarcerated metacarpophalangeal dislocation admitted from 1997 to 2006 were studied retrospectively. The age ranged from 8 to 33 years（mean 17 years）. All the types were the dorsal dislocation. The dislocation were occurred on index finger in 3 cases,thumb in 2 cases,middle finger in 1 case and small finger in 1 case. Results：All the patients were followed up from 3 to 42 months with an average time of 21 months. Operative finding revealed the rupture of volar capsule and entrapment of metacarpal head. The joint function and postoperative X-ray showed anatomical reduction were good in all the patients. Conclusion：Repeated manipulative reduction should not be advocated if the close reduction was not successful. In order to avoid influencing the joint function,early open reduction of acute complex metacarpophalangeal dislocation is necessary.

关 键 词：掌指关节 脱位 外科手术 

分 类 号：R684.7[医药卫生—骨科学] R696[医药卫生—外科学]