Abstract:
A retrospective review was conducted of 500 consecutive patients who underwent surgery for complete collateral ligament ruptures of their thumb metacarpophalangeal (MP) joints comprising 362 ulnar collateral and 138 radial collateral ligaments. Complete rupture was confirmed in all cases at surgery. When surgery was carried out within 3 weeks of the injury, reinsertion of the ligament was pos- sible in 98% of cases. When surgery was performed after 3 weeks, reinsertion of the ligament was possible in 45% of ulnar and 68% of radial injuries. Reconstruction utilizing a free tendon graft was required for the other cases. All patients who had surgery within 3 weeks of their injuries regained stable, pain free thumbs. Surgery was less suc- cessful in patients who had surgery after 3 weeks and the failure rate was 5%. Surgery within 3 weeks of the injury permitted re-insertion of the ligament in almost all cases. We propose that avulsions treated within that period be referred to as \"acute\" injuries and those treated later as \"chronic.\" Treatment of acute injuries is preferred because they rarely require reconstruction, and the results were better than when surgery was performed for chronic injuries. Repair of thumb MP collateral ligaments is predictably possible within 3 weeks of injury but less likely if surgery is delayed after that time period.
摘要:
对500例连续患者进行了回顾性研究,这些患者接受了拇指掌指关节(MP)完全侧副韧带破裂的手术,包括362条尺侧副韧带和138条桡侧副韧带。所有病例均在手术中确认完全破裂。当手术在受伤后3周内进行时,98%的病例有可能重新插入韧带。3周后进行手术时,45%的尺骨和68%的radial骨损伤可以重新插入韧带。其他病例需要使用游离肌腱移植物进行重建。所有在受伤后3周内接受手术的患者恢复了稳定,无痛拇指。3周后手术的患者手术成功率较低,失败率为5%。在损伤后3周内的手术几乎允许在所有情况下重新插入韧带。我们建议在这段时间内治疗的撕脱被称为“急性”损伤,后来被称为“慢性”损伤。“急性损伤的治疗是首选,因为它们很少需要重建,结果优于对慢性损伤进行手术。拇指MP侧支韧带的修复在损伤后3周内是可能的,但如果手术在该时间段后延迟,则可能性较小。