Thumb Carpometacarpal Instability.
| Autor: | Rabinovich RV; From the Attending Hand Surgeon, New York Hand & Wrist Center of Lenox Hill, New York, NY (Rabinovich, Beldner, and Polatsch), and the Attending Hand Surgeon, Cedars-Sinai Kerlan-Jobe Institute, Los Angeles, CA (Shin)., Polatsch DB, Shin SS, Beldner S |
|---|---|
| Jazyk: | angličtina |
| Zdroj: | The Journal of the American Academy of Orthopaedic Surgeons [J Am Acad Orthop Surg] 2021 Nov 15; Vol. 29 (22), pp. 943-950. |
| DOI: | 10.5435/JAAOS-D-21-00310 |
| Abstrakt: | The basal joint complex of the thumb provides the framework necessary for function of the human hand. Although its unique saddle articulation allows for a wide range of motion necessary for routine function of the hand, it is rendered inherently unstable because of poor bony congruency and reliance on its capsuloligamentous support. Painful instability of this joint can stem from several causes including traumatic dislocation, various hypermobility conditions, and chronic overuse and microtrauma. A thorough history and examination as well adequate imaging is necessary for proper evaluation of instability. Treatment options range from nonoperative modalities to surgery, which entails closed, percutaneous, or open reduction with numerous ligament repair and reconstruction techniques. Arthroscopy can also serve to be a useful adjunct for assessment of the joint and stabilization of the critical capsuloligamentous structures. This review outlines the critical osseous and soft-tissue anatomy surrounding the thumb carpometacarpal joint, the key points in evaluating patients presenting with acute traumatic and chronic thumb carpometacarpal instability without fracture or arthritis, and reviews both nonoperative and operative treatments of this injury. (Copyright © 2021 by the American Academy of Orthopaedic Surgeons.) |
| Databáze: | MEDLINE |
| Externí odkaz: |
|