OBJECTIVE To introduce the surgical procedure and clinical result of microsurgical repair on collateral ligament rupture in the interphalangeal joint using superficial flexor tendon of finger. METHODS From 1987, 23 cases with collateral ligament rupture in the interphalangeal joint were repaired by part of superficial flexor tendon of finger. The initial point of collateral ligament was drilled two holes, 2 to 3 mm in distance, and crossed by steel wire. Then the superficial flexor tendon of finger was crossed under the steel wire and sutured to the terminal point of superficial flexor tendon of finger by 5/0 to 7/0 nontraumatic suture thread to maintain suitable tension, and sutured to collateral ligament by 8/0 nontraumatic suture thread. Extension splint fixation was performed 4 to 6 weeks postoperatively. RESULTS Followed up 3 to 6 months, 15 cases were excellent, 6 cases were better, 2 cases were moderate, and the excellent rate was 91.34% according to Saetta standard. CONCLUSION Microsurgical repair on collateral ligament rupture in the interphalangeal joint using superficial flexor tendon of finger is a convenient and effective surgical method.
Objective To investigate the self-made classification criterion for mucous cysts of distal interphalangeal joint and the effectiveness of the surgical treatment. Methods Between July 2008 and August 2015, 33 patients with mucous cysts of distal interphalangeal joint were treated, and the clinical data were retrospectively analyzed. Among 33 cases, 15 were male and 18 were female, aged from 45 to 74 years (mean, 58 years). The disease duration ranged from 3 weeks to 1 year (mean, 5 months). The cyst located at thumb in 18 cases, index finger in 4 cases, middle finger in 6 cases, ring finger in 4 cases, and little finger in 1 case. According to location, mucous cysts were typed: proximity to one side of the finger extensor tendon and deviation from the midline of the finger named lateral type (22 cases); and at both sides of the finger extensor tendon named intermediate type (11 cases). The bilateral digital dorsal incision was made in the intermediate type patients, and the reverse L-shaped incision was made in the lateral type patients, then the degenerative tissue was resected, the osteophyte was removed, and the capsule was repaired; finally, mucous cysts were resected. Results All the patients were followed up 4 months to 2 years (mean, 14.5 months). The incision healed by first intention without infection after operation. Clinical symptoms obtained improvement and no recurrence was observed in 29 patients except 4 patients who died of other diseases during follow-up. Conclusion A surgical treatment for mucous cysts of distal interphalangeal joint is feasible according to the self-made classification criterion and it has the advantage of simple operation and definite effectiveness.
ObjectiveTo investigate the diagnosis and treatment of thumb polydactyly with symphalangism in children.MethodsSeven cases of thumb polydactyly with symphalangism were treated between January 2013 and May 2017. There were 5 males and 2 females, aged from 10 months to 11 years, with an average age of 3.1 years. The thumb-polydactyly was diagnosed with MRI and it was seen that the base of radial multi-finger and the proximal phalangeal joint were connected by cartilage. All patients were treated with resection, lateral collateral ligament reconstruction, bone osteotomy and internal fixation.ResultsThe operation was successfully completed, and there was no early complications such as infection and flap necrosis. All patients were followed up 6-23 months (mean, 14.1 months). At last follow-up, there was no deformity finger, scar contracture, and other complications. The extension of the interphalangeal joint was no limited, and the flexion range of the interphalangeal joint was 20-75° (mean, 56.7°). The appearance and function of the thumb was rated as excellent in 3 cases and good in 4 cases by Japanese Society for Surgery of the Hand (JSSH) scoring, with the excellent and good rate of 100%.ConclusionThe thumb polydactyly with symphalangism in children can be combined with clinical manifestations, X-ray film, and MRI examination to diagnose, and can obtain satisfactory results through the reconstruction of lateral collateral ligament, bone osteotomy, and internal fixation.
ObjectiveTo summarize the research progress in artificial metacarpophalangeal joint and interphalangeal joint prostheses.MethodsThe research literature on artificial metacarpophalangeal joint and interphalangeal joint prostheses at home and abroad was reviewed and summarized from anatomy, prosthesis design, and material development.ResultsThe artificial joint replacement can correct deformity, relieve pain, and improve function immediately. In the past 50 years, many researches have focused on the design and material of prostheses and surgical technique of joint replacement. There are three types of prostheses, including hinged limit-type-prosthesis, semi-limit-type-prosthesis, and non-limit-type-prosthesis. The prostheses have their own advantages and disadvantages, the long-term effectiveness of joint replacement is not ideal.ConclusionThe metacarpophalangeal joint and interphalangeal joint prostheses with more anatomical structure and biocompatible materials are needed.