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題 名 | Acute Traumatic Closed Mallet Thumb Associated with Extensor Pollicis Brevis Tendon Injury Mimicking a Dropped Thumb Deformity--Case Report=急性創傷閉鎖性槌狀拇指合併伸拇短肌腱傷害誤解為垂落拇指變形--個案報告 |
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作 者 | 李璧蓉; 潘信誠; 邱浩遠; 李曜洲; | 書刊名 | 臺灣整形外科醫學會雜誌 |
卷 期 | 22:2 2013.06[民102.06] |
頁 次 | 頁133-137 |
分類號 | 416.615 |
關鍵詞 | 創傷閉鎖性槌狀拇指; 伸拇短肌腱; 肌腱斷裂; 垂落拇指變形; Dropped thumb; Extensor pollicis longus tendon; Mallet thumb; Tendon rupture; |
語 文 | 英文(English) |
中文摘要 | 背景:創傷閉鎖性槌狀拇指是很罕見的情況,由於它的罕見及獨特的解剖學特性增加了診斷及治療上的困難度,保守治療或是手術治療也仍未定論。目的及目標:我們分享了我們在診斷及治療急性創傷閉鎖性槌狀拇指合併伸拇短肌腱傷害的經驗,文中也會針對槌狀拇指傷害的診斷及治療相關文獻做回顧。材料及方法:一位28歲的男性因為在手部鼻煙窩處有一2公分的撕裂傷並且以垂落拇指變形來表現而到急診室就診,直覺地診斷為伸拇長肌腱於Verdan第四區斷裂,然而於開刀探查後才發現,確定診斷其實為急性創傷閉鎖性槌狀拇指傷害合併伸拇短肌腱部分斷裂。結果:斷裂的伸拇長肌腱在將斷端近端拉回後,並且固定大拇指指間關節於伸展狀態下,可以直接進行縫合修補,大拇指指間關節被暫時性地固定在伸展狀態下六週,在之後的追蹤,病人大拇指指間關節可以達到完全性的自主伸展。結論:診斷槌狀拇指傷害在有伴隨其它傷害時是特別的困難,臨床上的懷疑需藉著對於解剖學、生物力學、功能性理學檢查的良好知識,在治療上,我們的個案利用手術的方式修補可以達到令人滿意的結果。 |
英文摘要 | Background:Acute traumatic closed mallet thumb injury is an extremely rare entity. Its rarity and unique anatomic characteristics increase the difficulties in diagnosis and management. Conservative or operative treatment is also under debate.Aim and Objectives:We share our experience in the diagnosis and management of acute traumatic closed mallet thumb complicated by the associated extensor pollicis brevis tendon injury. Literatures regarding the diagnosis and management of mallet thumb injury are also reviewed in this article.Materials and Methods:A 28-year-old man presented to emergency department with a 2-cm laceration within the anatomic snuffbox and manifested with dropped thumb deformity. The extensor pollicis longus tendon severance at Verdan's zone IV was impressed intuitively. However, acute traumatic closed mallet thumb associated with extensor pollicis brevis tendon partial severance turned out to be the diagnosis after the exploration.Results:The extensor pollicis longus tendon was repaired after approximation by exerting traction on the proximal end and with the thumb in extension position. The interphalangeal joint was temporarily immobilized in extension for 6 weeks. Full extension of the interphalangeal joint of the thumb was achieved at the follow up.Conclusion:Diagnosis of the closed mallet thumb injury is difficult especially in the situations complicated with the associated injuries. Clinical suspicion depends on the good knowledge of anatomy, biomechanics, and functional examinations. Operative treatment achieved satisfactory outcome in our case. |
本系統中英文摘要資訊取自各篇刊載內容。