早期手术切开复位治疗新鲜嵌顿性掌指关节脱位.pdfVIP

中国骨伤2008年4月第21卷第4期 China J Orthop＆Trauma，Apr．2008，Vo1．21，No．4 · 293· · 经 验 交 流 · 早期手术切开复位治疗新鲜嵌顿性掌指关节脱位 王万宏 ，侯春林 ，谭晓毅 ，王颖 (1．宜昌市第一人民医院骨科，湖北 宜昌 443000；2．上海长征医院骨科) 【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。 【关键词】 掌指关节； 脱住； 外科手术 Early open reduction of acute incarcerafied metacarpophalangeal dislocation WA NG Wan-hong 。HOU Chun-lin，TA N Xiao-yi，WANG Ying． Department ofOrthopaedics，the FirstPeople HospitalofYichang，Yichang 443000，Hubei，China ABSTRACT 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 re- duction was not successfu1．In order to avoid influencing the joint function，early open reduction of acute complex metacar- pophalangeal dislocation is necessary． Key words Metacarpophalangeal joint； Dislocation；Surgical procedures，operative Zhongguo Gu