近指间关节掌侧关节镜的初步临床应用  

Preliminary clinical application of the volar arthroscopy of proximal interphalangeal joint

作　　者：赵喆[1] 李文翠[1] 刘建全[1] 耿红荔 邓志钦 李永胜[1] 陈小强 王光辉[1] 尹建文 李嘉贝 程翔宇 Zhao Zhe;Li Wencui;Liu Jianquan;Geng Hongli;Deng Zhiqin;Li Yongsheng;Chen Xiaoqiang;Wang Guanghui;Yin Jianwen;Li Jiabei;Cheng Xiangyu(Department of Foot Ankle and Hand Surgery,Shenzhen Second People′s Hospital(the First Affiliated Hospital of Shenzhen University),Shenzhen 518025,China)

机构地区：[1]深圳市第二人民医院(深圳大学第一附属医院)足踝外科手外科,深圳518025

出　　处：《中华手外科杂志》2022年第5期407-411,共5页Chinese Journal of Hand Surgery

摘　　要：目的探讨一种新的手指关节镜入路:近指间关节掌侧关节镜入路的安全性及初步临床应用。方法利用inside-out技术在近指间关节侧方掌板深面建立入路,可观察到近指间关节掌侧结构并进行关节腔内操作。自2018年5月至2020年9月,我科利用该技术行关节掌侧游离骨折块取出4例、松解单纯掌板挛缩4例、关节腔内增生滑膜切除2例。结果所有手术均达术前目标,4例掌侧骨块均在关节镜下取出;挛缩的掌板经镜下刨刀打磨后变薄,经手法松解后可在镜下见屈肌腱显露,可将挛缩的关节完全被动伸直;关节肿痛患者经镜下滑膜切除后,肿痛消退。10例患者中1例出现术后手指麻木,术后6周麻木自行缓解。结论近指间关节掌侧入路较为安全,可完成关节掌侧病变的处理,初步临床应用取得良好效果。Objective To investgate the safety and preliminary clinical application of a new finger arthroscopic approach:proximal interphalangeal joint volar arthroscopic approach.Methods The inside-out technique was used to establish an approach on the deep surface of the volar plate on the side of the proximal interphalangeal joint,and the volar structure of the proximal interphalangeal joint could be observed and operated in the joint cavity.From May 2018 to September 2020,using this technique,4 cases of volar free fracture were removed,4 cases of simple volar contracture were released,and 2 cases of proliferative synovectomy in articular cavity were performed.Results All the operations achieved the preoperative goals,and the volar bone fragments of 4 cases were removed under arthroscope.The contracture volar plate becomes thinner after grinding with a planer under the arthroscope.After manual release,the flexor tendon can be exposed under the arthroscope,which can completely passively straighten the contracture joint.After synovectomy under the arthroscope,the swelling and pain subsided in patients with joint swelling and pain.One of the 10 patients had postoperative numbness of fingers,which eased spontaneously 6 weeks after operation.Conclusion The volar approach of interphalangeal joint is relatively safe,which can complete the treatment of volar joint lesions.The preliminary clinical application has achieved good results.

关 键 词：骨折 关节镜 指间关节 掌板 滑膜 

分 类 号：R687.4[医药卫生—骨科学]