[The value of early ligament repair in severe sprains of the trapezoid-metacarpal joint. Apropos of 10 cases].
The diagnosis of ligamentous injuries of the carpometacarpal joint of the thumb is too often missed or imprecise. Inadequate treatment may cause chronic instability and secondary rhizarthrosis. The important range of motion of the thumb arises from this joint, which is stabilized by ligaments that are liable to injury. The authors report the results of 10 ligament plasties, performed acutely on recent sprains, of which 8 were caused by sports injuries. Ball sports are usually responsible for radial instability from rupture of the strong ulnar ligament by sudden radial hyperabduction; this is treated by a plasty with the flexor carpi radialis, according to Eaton and Littler. Contact sports usually are the cause of ulnar instability by sudden retropulsion of the thumb; this is treated by a plasty with the abductor pollucis longus, according to Brunelli. These sports may also cause axial compression of the flexed thumb, resulting in radial instability from rupture of the capsuloligamentous structures; this lesion is treated by an augmentation plasty as proposed by Péquignot et al. (extensor carpi radialis brevis and abductor pollicis longus).
Fontes
D
D
Service de Chirurgie Orthopédique et de Traumatologie, Hôpital Ambroise Paré, Boulogne, France.
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008023:Ligaments, Articular / Q000601:surgery*; D008297:Male; D016059:Range of Motion, Articular; D013180:Sprains and Strains / Q000534:rehabilitation / Q000601:surgery*; D013933:Thumb; D014954:Wrist Injuries / Q000534:rehabilitation / Q000601:surgery*; D014955:Wrist Joint / Q000502:physiology
Intérêt d'une ligamentoplastie précoce dans les entorses graves de l'articulation trapézo-métacarpienne. A propos de 10 cas.