大多角骨切除加肌腱固定术治疗第一腕掌关节炎的疗效观察

目的介绍大多角骨切除加肌腱固定术治疗第一腕掌关节炎的手术方法及疗效。方法以大多角骨完全切除加部分桡侧腕屈肌腱固定第一掌骨基底部的方法治疗第一腕掌关节炎11例。测量患侧手术前后及健侧腕关节和拇指的活动度、握力和捏持力,进行统计学分析。结果11例中的10例随访1～3年,平均2年3个月,比较术后和术前腕关节及拇指活动范围和握力及捏持力,术后有明显的增加,术前、术后相比差异有统计学意义(P<0.01)。术后与健侧对比差异无统计学意义(P>0.05)。结论大多角骨切除加桡侧腕屈肌腱固定第一掌骨基底部治疗第一腕掌关节炎是一种可行的方法值得临床推广。

Curative effectiveness of trapezium incision combined with tendon fixation treating osteoarthritis of the trapeziometacarpal joint

Objective To introduce a new surgical method to deal with osteoarthritis of carpometacarpal joint.Methods Eleven cases of osteoarthritis of carpometacarpal joint were treated by full excision of the trapezium and reconstruction of the first intermetacarpal ligament by using the distally based half of the flexor carpi radialis (FCR) tendon.The range of motion of wrist,thumb and the grip and pinch strength were measured pre- and postoperatively.Data were collected on 11 hands in 11 patients.Results The follow-up period was 1 year to 3 years.There was significant difference in the range of motion of wrist,thumb and the grip and pinch strength before and after operation (P<0.01).Both the range of motion and the strength were significantly improved after operation.However,there was no significant difference between affected hands and normal hands after operation (P>0.05).Conclusion It is a feasible method that full excision of the trapezium and reconstruction of the first intermetacarpal ligament by using the distally based half of the FCR tendon in the treatment of osteoarthritis of carpometacarpal joint.