论著

腕关节镜辅助微创治疗月骨周围脱位

  • 刘波 ,
  • 陈山林 ,
  • 朱瑾 ,
  • 王志新 ,
  • 杨辰 ,
  • 沈杰 ,
  • 田光磊
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  • (北京积水潭医院手外科,北京100035)

网络出版日期: 2016-04-18

基金资助

首都卫生发展科研专项项目(2011-2007-02)、北京市“十百千”卫生人才“千”层次项目(2011)和北京积水潭医院FRCS人才培训基金(2013)资助

Arthroscopic management of lesser arc perilunate injuries

  • LIU Bo ,
  • CHEN Shan-lin ,
  • ZHU Jin ,
  • WANG Zhi-xin ,
  • YANG Chen ,
  • SHEN Jie ,
  • TIAN Guan-lei
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  • (Department of Hand Surgery, Beijing Jishuitan Hospital, Beijing, 100035, China)

Online published: 2016-04-18

Supported by

Supported by the Capital Health Research and Development of Special (2011-2007-02), Thousand Class Talent of Beijing Municipal Health Bureau Tenhundredthousand Project(2011) and Beijing Jishuitan Hospital foundation for FRCS training (2013)

摘要

目的:评估腕关节镜辅助微创复位固定治疗月骨周围脱位的效果。方法:从2012年至2014年北京积水潭医院采用腕关节镜辅助微创治疗的5例月骨周围脱位患者进行随访,平均随访时间17.8个月(10~32个月)。临床治疗效果评估内容包括腕关节活动度、握力、Mayo腕关节评分、Quick DASH(disabilities of the arm, shoulder and hand)评分和PRWE(patient-rated wrist evaluation)评分。影像学评估内容包括腕关节力线恢复和保持情况,以及是否存在关节炎表现。结果: 患侧平均屈伸活动度为健侧的84%,握力为健侧的90%; 平均Quick DASH评分为1, PRWE评分为5。根据Mayo腕关节评分,术后功能5例患者平均得分92分,均为优,最后随访时的影像学检查显示所有患者术后腕关节力线都得以恢复和维持,未见腕关节骨性关节炎的征象。结论:腕关节镜辅助微创复位和固定治疗月骨周围脱位的早期随访结果满意,可能是一个有效和值得推荐的治疗选择。

本文引用格式

刘波 , 陈山林 , 朱瑾 , 王志新 , 杨辰 , 沈杰 , 田光磊 . 腕关节镜辅助微创治疗月骨周围脱位[J]. 北京大学学报(医学版), 2016 , 48(2) : 234 -236 . DOI: 10.3969/j.issn.1671-167X.2016.02.010

Abstract

Objective:To evaluate the outcomes of lesser arc perilunate injuries (Perilunate dislocations) treated with arthroscopically assisted mini-invasive reduction and fixation. Methods: Between 2012 and 2014, 5 patients who had a perilunate dislocation were treated with arthroscopically assisted reduction and percutaneous fixation. The mean follow-up was 17.8 months (range, 10 to 32 months). Clinical outcomes were evaluated on the basis of range of motion; grip strength; Mayo wrist score; Quick disabilities of the arm, shoulder and hand questionnaire; and patient-rated wrist evaluation score. Radiographic evaluations included carpal alignments and any development of arthritis. Results: The range of flexion-extension motion of injured wrist averaged 84% of the values for contralateral wrist. The grip strength of the injured wrist averaged 90% of the values for the contralateral wrists. The mean Quick Disabilities of the arm, shoulder and hand score was 1, and the mean Patient-Rated Wrist Evaluation score was 5. According to the Mayo wrist scores, the overall functional outcomes were rated as excellent in all the patients. Reduction obtained during the operation was maintained within normal ranges in all the patients. Arthritis had not developed in any patient at the end of the follow-up. Conclusion: Arthroscopic mini-invasive reduction with percutaneous fixation is a reliable and favorable alternative in the treatment of perilunate dislocations according to our early results.

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