• 河北聯(lián)合大學(xué)附屬骨科醫(yī)院 唐山市第二醫(yī)院手外二科（河北唐山，063000）;

目的 探討克氏針絲線張力帶治療拇指掌指關(guān)節(jié)尺側(cè)副韌帶撕脫骨折的臨床療效。 方法 2008年9 月－2011年10月，收治14例拇指掌指關(guān)節(jié)尺側(cè)副韌帶撕脫骨折患者。男8例，女6例；年齡23～55歲，平均40.8歲。致傷原因：機(jī)器扭轉(zhuǎn)傷5例，人力扭轉(zhuǎn)傷4例，跌傷4例，運(yùn)動傷1例。受傷至手術(shù)時間2 h～14 d?；颊吣粗刚浦戈P(guān)節(jié)疼痛，活動受限，掌指關(guān)節(jié)尺側(cè)側(cè)方應(yīng)力試驗陽性。采用克氏針絲線張力帶固定骨折，2周后開始功能鍛煉。 結(jié)果術(shù)后切口均Ⅰ期愈合，拇指掌指關(guān)節(jié)尺側(cè)側(cè)方應(yīng)力試驗陰性。患者均獲隨訪，隨訪時間6～18個月，平均13.1個月。X線片檢查示骨折復(fù)位、愈合良好，愈合時間為4～10周，平均7周。末次隨訪時，患指掌指關(guān)節(jié)屈伸活動穩(wěn)定，對指功能正常，手指抓捏功能正常。按照Saetta等標(biāo)準(zhǔn)評價術(shù)后功能，獲優(yōu)11例，良3例，優(yōu)良率達(dá)100%。 結(jié)論克氏針絲線張力帶具有手術(shù)操作簡便、術(shù)后功能鍛煉早、功能恢復(fù)滿意的優(yōu)點(diǎn)，是治療拇指掌指關(guān)節(jié)尺側(cè)副韌帶撕脫骨折的有效方法之一。

引用本文： 高順紅馮仕明焦成. 克氏針絲線張力帶治療拇指掌指關(guān)節(jié)尺側(cè)副韌帶撕脫骨折. 中國修復(fù)重建外科雜志, 2012, 26(12): 1466-1468. doi: 復(fù)制

1. Patel S, Potty A, Taylor EJ, et al. Collateral ligament injuries of the metacarpophalangeal joint of the thumb: a treatment algorithm. Strategies Trauma Limb Reconstr, 2010, 5(1): 1-10.
2. Tang P. Collateral ligament injuries of the thumb metacarpophalangeal joint. J Am Acad Orthop Surg, 2011, 19(5): 287-296.
3. Papandrea RF, Fowler T. Injury at the thumb UCL: is there a Stener lesion? J Hand Surg (Am), 2008, 33(10): 1882-1884.
4. Chuter GS, Muwanga CL, Irwin LR. Ulnar collateral ligament injuries of the thumb: 10 years of surgical experience. Injury, 2009, 40(6): 652-656.
5. Ritting AW, Baldwin PC, Rodner CM. Ulnar collateral ligament injury of the thumb metacarpophalangeal joint. Clin J Sport Med, 2010, 20(2): 106-112.
6. Anderson D. Skier’s thumb. Aust Fam Physician, 2010, 39(8): 575-577.
7. Frank WE, Dobyns J. Surgical pathology of collateral ligamentous injuries of the thumb. Clin Orthop Relat Res, 1972, (83): 102-114.
8. Camp RA, Weatherwax RJ, Miller EB. Chronic posttraumatic radial instability of the thumb metacarpophalangeal joint. J Hand Surg (Am), 1980, 5(3): 221-225.
9. Saetta JP, Phair IC, Quinton DN. Ulnar collateral ligament repair of the metacarpo-phalangeal joint of the thumb: a study comparing two methods of repair. J Hand Surg (Br), 1992, 17(2): 160-163.
10. Smith RJ. Post-traumatic instability of the metacarpophalangeal joint of the thumb. J Bone Joint Surg (Am), 1977, 59(1): 14-21.
11. Dinowitz M, Trumble T, Hanel D, et al. Failure of cast immobilization for thumb ulnar collateral ligament avulsion fractures. J Hand Surg (Am), 1997, 22(6): 1057-1063.
12. Kozin SH, Bishop AT. Tension wire fixation of avulsion fractures at the thumb metacarpophalangeal joint. J Hand Surg (Am), 1994, 19(6): 1027-1031.
13. Baskies MA, Lee SK. Evaluation and treatment of injuries of the ulnar collateral ligament of the thumb metacarpophalangeal joint. Bull NYU Hosp Jt Dis, 2009, 67(1): 68-74.
14. Rettig A, Rettig L, Welsch M. Anatomic reconstruction of thumb metacarpophalangeal joint ulnar collateral ligament using an interference screw docking technique. Tech Hand Up Extrem Surg, 2009, 13(1): 7-10.
15. Katolik LI, Friedrich J, Trumble TE. Repair of acute ulnar collateral ligament injuries of the thumb metacarpophalangeal joint: a retrospective comparison of pull-out sutures and bone anchor techniques. Plast Reconstr Surg, 2008, 122(5): 1451-1456.
16. Watanabe K. A simple method of osteosynthesis for avulsion fractures of the thumb metacarpophalangeal joint. Hand Surg, 2005, 10(2-3): 209-211.
  1. 1. Patel S, Potty A, Taylor EJ, et al. Collateral ligament injuries of the metacarpophalangeal joint of the thumb: a treatment algorithm. Strategies Trauma Limb Reconstr, 2010, 5(1): 1-10.
  2. 2. Tang P. Collateral ligament injuries of the thumb metacarpophalangeal joint. J Am Acad Orthop Surg, 2011, 19(5): 287-296.
  3. 3. Papandrea RF, Fowler T. Injury at the thumb UCL: is there a Stener lesion? J Hand Surg (Am), 2008, 33(10): 1882-1884.
  4. 4. Chuter GS, Muwanga CL, Irwin LR. Ulnar collateral ligament injuries of the thumb: 10 years of surgical experience. Injury, 2009, 40(6): 652-656.
  5. 5. Ritting AW, Baldwin PC, Rodner CM. Ulnar collateral ligament injury of the thumb metacarpophalangeal joint. Clin J Sport Med, 2010, 20(2): 106-112.
  6. 6. Anderson D. Skier’s thumb. Aust Fam Physician, 2010, 39(8): 575-577.
  7. 7. Frank WE, Dobyns J. Surgical pathology of collateral ligamentous injuries of the thumb. Clin Orthop Relat Res, 1972, (83): 102-114.
  8. 8. Camp RA, Weatherwax RJ, Miller EB. Chronic posttraumatic radial instability of the thumb metacarpophalangeal joint. J Hand Surg (Am), 1980, 5(3): 221-225.
  9. 9. Saetta JP, Phair IC, Quinton DN. Ulnar collateral ligament repair of the metacarpo-phalangeal joint of the thumb: a study comparing two methods of repair. J Hand Surg (Br), 1992, 17(2): 160-163.
  10. 10. Smith RJ. Post-traumatic instability of the metacarpophalangeal joint of the thumb. J Bone Joint Surg (Am), 1977, 59(1): 14-21.
  11. 11. Dinowitz M, Trumble T, Hanel D, et al. Failure of cast immobilization for thumb ulnar collateral ligament avulsion fractures. J Hand Surg (Am), 1997, 22(6): 1057-1063.
  12. 12. Kozin SH, Bishop AT. Tension wire fixation of avulsion fractures at the thumb metacarpophalangeal joint. J Hand Surg (Am), 1994, 19(6): 1027-1031.
  13. 13. Baskies MA, Lee SK. Evaluation and treatment of injuries of the ulnar collateral ligament of the thumb metacarpophalangeal joint. Bull NYU Hosp Jt Dis, 2009, 67(1): 68-74.
  14. 14. Rettig A, Rettig L, Welsch M. Anatomic reconstruction of thumb metacarpophalangeal joint ulnar collateral ligament using an interference screw docking technique. Tech Hand Up Extrem Surg, 2009, 13(1): 7-10.
  15. 15. Katolik LI, Friedrich J, Trumble TE. Repair of acute ulnar collateral ligament injuries of the thumb metacarpophalangeal joint: a retrospective comparison of pull-out sutures and bone anchor techniques. Plast Reconstr Surg, 2008, 122(5): 1451-1456.
  16. 16. Watanabe K. A simple method of osteosynthesis for avulsion fractures of the thumb metacarpophalangeal joint. Hand Surg, 2005, 10(2-3): 209-211.