拇指基底部由大多角骨與掌骨形成腕掌關節又稱基底關節,由於其特殊的馬鞍形構造及關節周圍之強勁韌帶支持,維持關節的穩定性。 拇指基底關節的外傷外,常見的情形是合併骨折與脫臼同時發生;單純的脫臼或半脫臼情形則屬少見,後者由於關節的穩定性喪失,多需要施予韌炎重建手術以維持關節的穩定性。 本文報告一位32歲、男性病例,因車禍外傷造成慢性姆指腕掌關節脫臼,經施行手術整復,並以橈側屈腕肌腱重建關節之穩定性(Eaton和Littler氏法),經過三年多的追蹤觀察,患者目前從事大型貨車駕駛工作,雖然舉拿重物時稍有疼痛,但獲得穩定之關節復位,其臨床結果令人滿意。
Pure dislocation or subluxation of the thumb carpo-metacarpal (CMC)joint, which is different from fracture-dislocation, is a rare clinical condition. A patient with chronic traumatic subluxation of the basal joint was treated by open reduction and ligamentous reconstruction with FCR tendon graft (Eaton and Littler’s technique) at the FEMH. The result of our patient remains satisfactory after 3 years’ follow up.