拇指籽骨翻转脱位致掌指关节绞锁的诊治  

Diagnosis and treatment of the metacarpophalangeal joint locking caused by sesamoid turned over dislocation of the thumb

作　　者：王西迅 李钧 童哲 孙文海[2] 陈波 胡继超 崔岩 魏勇 潘跃 

机构地区：[1]中国武装警察部队浙江省总队医院手足外科,浙江嘉兴314000 [2]山东省立医院手足外科

出　　处：《中国骨伤》2009年第4期263-264,共2页China Journal of Orthopaedics and Traumatology

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。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.

关 键 词：拇指 籽骨 掌指关节 外科手术 

分 类 号：R681.7[医药卫生—骨科学] R681.3[医药卫生—外科学]