双套圈交叉缝合治疗急性拇指Stener损伤△

Double ring cross suture for acute Stener injury of the thumb

摘要:

目的 介绍双套圈交叉缝合治疗急性拇指 Stener 损伤的手术技术和初步临床效果。［方法］ 2012 年 5 月—2019 年 7 月，采用双套圈交叉缝合治疗急性拇指 Stener 损伤共 12 例，重建拇指掌指关节尺侧副韧带止点，术后拇人字石膏下托固定 4 周，不固定指间关节，期间行指间关节屈伸练习，4 周后去除石膏下托，改用支具固定 2 周，不固定腕关节及指间关节，逐渐锻炼伤指功能。［结果］ 术后 12 例均获得 7~25 个月随访，拇指掌指关节稳定，活动正常，尺侧侧方应力试验阴性，捏力正常，手背及指背感觉正常。根据 Saetta 等评定标准：优 10 例，良 1 例，可 1 例，优良率为 91.67%。［结论］ 对于急性拇指 Stener 损伤的治疗，采用双套圈交叉缝合的方法可能是一种更好的选择。

Abstract:

[Objective] To introduce the surgical technique and preliminary clinical outcomes of double ring cross suture for repairing acute Stener injury of thumb. [Methods] From May 2012 to July 2019, a total of 12 patients received double ring cross suture for acute Sten- er injury of thumb with lateral collateral ligament insertion reconstruction. The thumb spica cast without involving interphalangeal joint line was used for external fixation for 4 weeks postoperatively, with active interphalangeal joint exercises. After the cast was removed, a brace was used for another 2 weeks without involving the wrist and interphalangeal joints, and progressing rehabilitation of the affected finger was conducted. [Results] All the 12 patients were followed up for 7~25 months. At the latest follow up, the metacarpophalangeal joint of thumb was stable and normal, with negative the ulnar stress test, normal pinching force, and normal sensation of the back of the hand and finger. According to Saetta's criteria, the outcome was graded as excellent in 10 cases, good in 1 case and fair in 1 case, with the excellent and good rate of 91.67%. [Conclusion] This double ring cross suture may be a better choice for the treatment of acute Stener injury of thumb.