首页|关节镜下桡尺远侧韧带重建治疗慢性PalmerⅠD型三角纤维软骨复合体损伤疗效观察

关节镜下桡尺远侧韧带重建治疗慢性PalmerⅠD型三角纤维软骨复合体损伤疗效观察

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目的:探讨腕关节镜辅助下异体肌腱重建桡尺远侧韧带治疗慢性 PalmerⅠD型三角纤维软骨复合体损伤伴桡尺远侧关节不稳的临床疗效.方法:回顾性分析我院2017年1月至2020年1月收治的15例慢性PalmerⅠD型三角纤维软骨复合体损伤患者临床资料,均给予腕关节镜辅助下异体肌腱重建桡尺远侧韧带治疗,术后随访并评价腕关节的活动度、腕关节疼痛视觉模拟评分(VAS评分)、握力、腕关节功能评分(改良Mayo评分).结果:所有患者术后随访12~24个月,平均18.15±2.20个月.术后15例患者腕关节疼痛VAS评分为2.56±0.69分,与术前的6.78±1.24分比较差异有统计学意义(P<0.05),疼痛显著缓解.术后患侧手和健侧手的握力比率为(76.18±9.72)%,与术前的(50.18±6.79)%比较差异具有统计学意义(P<0.05),握力显著增大.术后腕关节旋转活动度为(151.09±12.38)°,较术前的(142.87±10.19)°有显著改善,差异有统计学意义(P<0.05).按照改良Mayo评分,优8例,良6例,可1例,优良率为93.33%.结论:腕关节镜辅助下异体肌腱重建桡尺远侧韧带治疗慢性 PalmerⅠD型三角纤维软骨复合体损伤伴桡尺远侧关节不稳疗效确切,可促进疼痛、握力、旋转活动度的改善.
Arthroscopic ligament reconstruction in the treatment of chronic PalmerⅠD type triangular fibrochondral complex injury
Objective To explore the clinical effect of reconstructing distal radioulnar ligament with al-lograft tendon under wrist arthroscopy in the treatment of chronic PalmerⅠD type triangular fibrocarti-lage complex injury complicated with distal radioulnar joint instability.Methods Clinical data of 15 pa-tients with chronic PalmerⅠD type triangular fibrocartilage complex injury and admitted to our hospital between January 2017 to January 2020 were retrospectively analyzed.All of them were treated with wrist arthroscopic allograft tendon reconstruction of distal radioulnar ligament.During the postoperative follow-up,the wrist range of motion and grip strength were evaluated,while the wrist pain and wrist function were assessed using the visual analogue scale(VAS)and modified Mayo score.Results All pa-tients were followed up twelve to twenty-four months,with an average of(18.15±2.20)months.The postoperative VAS score was(2.56±0.69),significantly better than the preoperative one(6.78±1.24)(P<0.05).Moreover,the postoperative ratio of grip strength between the affected and the healthy hand was(76.18±9.72)%,significantly better than that of(50.18±6.79)%(P<0.05),with increased grip strength.Meanwhile,the postoperative rotational motion of wrist joint[(151.09±12.38)°]improved significantly compared with that before operation[(142.87±10.19)°](P<0.05).According to the modi-fied Mayo score,8 cases were excellent,6 cases were good,and 1 case was fair,reaching an excel-lent and good rate of 93.33%.Conclusion Wrist arthroscopic reconstruction of distal radioulnar liga-ment with allograft tendon is effective in the treatment of chronic PalmerⅠD type triangular fibrocarti-lage complex injury with lower radioulnar joint instability,relieving pain and promoting grip strength and rotational motion.

triangular fibrocartilage complex injurywrist arthroscopyligament reconstruction

杨顺、程亚博、向往、张静、陈柯屹、虞亚明

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四川省骨科医院(成都 610041)

三角纤维软骨复合体损伤 腕关节镜 韧带重建

2024

中国运动医学杂志
中国体育科学学会

中国运动医学杂志

CSTPCD北大核心
影响因子:0.856
ISSN:1000-6710
年,卷(期):2024.43(7)