Indications and techniques for thumb carpometacarpal arthrodesis.
Indications and techniques for thumb carpometacarpal arthrodesis.
复制标题
拇指腕掌关节融合术的适应症和技术。
DOI：
10.1097/00130911-200212000-00004
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发表时间：
2002
影响因子：
--
通讯作者：
P. Stern
中科院分区：
文献类型：
--
作者：
C. Goldfarb;P. Stern
拇指掌掌骨关节炎常见于绝经后妇女后掌喙韧带的衰减。不太常见的是，它可能在年轻男性拇指掌骨底部关节内骨折后出现。虽然大多数患者对非手术措施反应良好，但存在两种良好的手术治疗选择。关节成形术通常在老年、低需求的女性中进行，而关节融合术通常推荐给年轻患者。最近的研究表明，这两种方法的结果相似。拇指腕掌骨融合术是一种可靠和持久的治疗方法，效果非常好。它提供了出色的力量，令人满意的拇指活动范围，以及出色的患者满意度。该手术禁忌用于舟方关节关节炎患者。手术技术很简单，通常采用钢板螺钉或多根克氏针进行融合。虽然失败是罕见的，但良好的救助程序是存在的。并发症并不常见，但包括约13%的患者骨不连和与突出的硬体相关的疼痛。
Thumb carpometacarpal arthritis is seen commonly in postmenopausal women after attenuation of the volar beak ligament. Less commonly, it may be seen in young men after an intraarticular fracture of the base of the thumb metacarpal. Although most patients respond well to nonoperative measures, two good surgical treatment options exist. Arthroplasty is performed typically in older, low-demand women, and arthrodesis is often recommended in younger patients. Recent studies have demonstrated similar outcomes with these two procedures. Thumb carpometacarpal arthrodesis is a reliable and durable treatment with very good results. It provides excellent strength, satisfactory thumb range of motion, and excellent patient satisfaction. The procedure is contraindicated in patients with arthritis in the scaphotrapeziotrapezoid joint. The surgical technique is straightforward, and fusion is usually performed with either a plate and screw construct or with multiple Kirschner wires. Although failure is rare, good salvage procedures exist. Complications are uncommon but include nonunion in approximately 13% of patients and pain related to prominent hardware.