Trapeziometacarpal Joint Injuries

Journal of the Korean Society for Surgery of the Hand 1998;3(1):24-32.
Published online January 1, 1998.

Soo Bong Hahn,Eung Shick Kang,Ho Jung Kang,Han Sik Kim

제1 수지 수근중수간관절 손상

한수봉,강응식,강호정,김한식

Abstract

months, 6 Bennett's fractures, 2 Rolando's fractures, 2 epiphyseal injuries were satisfactory. The The treatment of 21 trapeziometacarpal joint(TMC) injuries was studied to provide an understanding of the pathomechanics and treatment principles for a good functional outcome. TMC joint has wide range of motion, complex articular surface, and greater muscular pull than other joints in hand. Injury of TMC joint can easily cause limitation of motion, deformity, pain, weakness, and posttraumatic osteoarthritis. Especially, the instability of TMC joint causes prolonged subluxation and weakness of pinch and grip. Twelve Bennett's fractures, 2 Rolando's fractures, 5 epiphyseal injurues, 1 pure dislocation without fracture, and 1 trapezium fracture were treated. Four Bennett's fractures and 3 epiphyseal injuries were immobilized in plaster cast after closed reduction. Five Bennett's fractures and 1 pure dislocation were treated by closed reduction and percutaneous pinning. Three Bennett's fractures and 2 epiphyseal injuries were treated by open reduction and pinning. Two comminuted Rolando's fractures were treated by open reduction, pinning, and intermetacarpal external fixation. At follow up after median 13 others showed pain, deformity, motion restriction, weakness, or subluxation. We concluded that restoration of articular surface, internal fixation againt the muscular pull, and stabilization of the joint were mandatory for a satisfactory outcome.