跖趾关节软骨移植修复掌指关节面缺损

目的　利用自体跖趾关节软骨移植修复掌指关节缺损的软骨面,为掌指关节创伤性关节炎提供简便、可靠的方法。方法　1990 年以来,应用改良处理后的自体跖趾关节面软骨移植修复9 例11 侧掌指关节面,通过内固定、侧副韧带修复并提供适宜的生物力学和营养环境。结果　经6 个月7 年随访,关节活动度平均增加35-1°,供趾骨融合良好,成形术后关节活动度减少甚至强直,但无疼痛,对行走无明显影响。结论　软骨面匹配良好,可靠的内固定、重建韧带、供区薄的软骨面和少的骨量及适宜的生物力学环境是手术成功的关键

REPAIR ON THE TRAUMATIC DEFECT OF METACARPOPHALANGEAL JOINT BY THE CARTILAGE TRANSPLANTATION OF METATARSOPHALANGEAL JOINT

Objective To present a simple and reliable method for the reconstruction of metacarpophalangeal joint by the cartilage transplantation of metatarsophalangeal joint. Methods From 1990, nine cases (11 sides)with traumatic metacarpophalangeal joint defect were treated by the autogenous cartilage transplantation of metatarsophalangeal joint followed by modified treatment. Appropriate biological mechanics was provided by internal fixation and collateral ligament repair. Results Followed up 6 months to 7 years, the range of joint motion was increased 35.1 degree. The fusion of dornor phalanges was fine, and the range of joint motion was decreased, even ankylosis after plastic operation, but no pain and no effect on walk.Conclusion The key to successful operation is better matching of cartilage, reliable internal fixation, ligament reconstruction, thin cartilage and little bone of the doner, appropriate biological mechanical surroundings.