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Surgical Repair of Dorsal Capsulo-Ligamentous Complex for Dislocation of the Thumb Carpometacarpal Joint

Surgical Repair of Dorsal Capsulo-Ligamentous Complex for Dislocation of the Thumb Carpometacarpal Joint

作     者:Haruhiko Shimura Tetsuya Sato Akimoto Nimura Yoshiaki Wakabayashi Koji Fujita 

作者机构:Department of Orthopedic Surgery Tokyo Bay Urayasu Ichikawa Medical Center Chiba Japan Department of Orthopedic Surgery Doai Memorial Hospital Tokyo Japan Department of Functional Joint Anatomy Graduate School of Medical and Dental Sciences Tokyo Medical and Dental University Tokyo Japan Department of Orthopedic Surgery Graduate School of Medical and Dental Sciences Tokyo Medical and Dental University Tokyo Japan 

出 版 物:《Open Journal of Orthopedics》 (矫形学期刊(英文))

年 卷 期:2019年第9卷第8期

页      面:145-151页

学科分类:1002[医学-临床医学] 100210[医学-外科学(含:普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

主  题:Thumb Carpometacarpal Joint Dislocation Dorsal Capsulo-Ligamentous Complex Surgical Repair Suture Anchors 

摘      要:Background: Acute dislocation of the thumb carpometacarpal (CMC) joint is a rare and challenging injury, and its treatment remains controversial. The purpose of the study was to evaluate the clinical outcome after surgical repair of the dorsal capsulo-ligamentous complex. Materials and methods: Eight patients with a mean age of 39.8 years (range, 23 - 56 years) treated for the thumb CMC joint were treated in our hospital between 2008 and 2018. The ruptured dorsal capsulo-ligamentous complex was repaired using suture anchors in all patients, and the joint was immobilized with a Kirschner wire pinning and splint for 3 weeks. The clinical outcome was assessed by measuring the range of motion of the thumb CMC joint and the Japanese Society for Surgery of the Hand version of the Quick Disability of the Arm, Shoulder, and Hand (Q-DASH-JSSH) score. Results: The mean radial abduction of the thumb CMC joint was 66°, and the volar abduction was 63°. The mean Q-DASH-JSSH score was 4.8 (range, 0 - 15.6). There were no cases of infection, nerve disturbance, or osteoarthritis. Anatomical reduction was observed in seven patients at the final follow-up and in a rugby football player at 6 months of follow-up;however, subluxation of the thumb CMC joint at 12 months of follow-up due to reinjury was observed. Conclusion: Surgical repair of the dorsal capsulo-ligamentous complex with suture anchors is a reliable and simple treatment for acute unstable dislocation of the thumb CMC joint.

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