摘要
目的评价腕关节镜下手术治疗三角纤维软骨复合体(triangular fibrocartilage complex,TFCC)损伤的临床疗效。方法选取2013年1月至2016年6月收治的TFCC损伤患者22例,男16例,女6例;年龄22~50岁,平均(31.50±8.27)岁。按照Palmer分型,Ⅰ型损伤16例(ⅠA型10例,ⅠB型4例,ⅠC型1例,ⅠD型1例),Ⅱ型损伤6例(ⅡA型2例,Ⅱb型1例,Ⅱc型3例)。诊断明确后,ⅠA、ⅠD型TFCC损伤关节镜下行单纯清创;ⅠB、ⅠC型损伤镜下行修补缝合术;Ⅱ型TFCC损伤行清创手术的同时进行软骨成形术。评价指标:腕关节的活动度、疼痛程度、握力、腕关节的功能评分(改良Mayo评分)。结果所有患者术后随访9~24个月,平均(17.60±5.10)个月。术后22例患者腕关节疼痛均较术前有不同程度缓解,握力得到改善,旋转活动度(157.05±3.26)°,桡尺偏角(39.45士1.60)°,腕关节屈伸度(126.95±1.65)°。按照改良Mayo评分,优14例,良6例,可2例,优良率为90.9%。结论腕关节镜诊疗TFCC损伤是一种微创、安全、有效的方式,随访效果确切满意,可作为腕关节尺侧疼痛的诊疗手段。
Objective To evaluate the effect of wrist arthroscopy in the treatment of triangular fibrocartilage complex injury.Methods Twenty-two patients with triangular fibrocartilage complex injury were enrolled in our hospital from January 2013 to June 2016.Among them,there were 16 males（73%）and 6 female（27%）patients with a mean age of（31.5±8.27）（range,22 to 5）years.According to Palmer classification,16 patients had typeⅠinjury（10 cases ofⅠA type,4 cases ofⅠB type,1 case ofⅠC type,1 case ofⅠD type）,and 6 cases had typeⅡinjury（2 cases of typeⅡA,1 case of typeⅡb,Ⅱc type 3 cases）.TheⅠA,ⅠD-type TFCC injury patients underwent simple debridement surgery;ⅠB,ⅠC-type injury patient underwent the suture repair;type Ⅱ TFCC injury patients underwent debridement surgery with cartilage surgery.Wrist activity,wrist pain,grip strength,wrist function score（improved Mayo score）were evaluated.Results All patients were followed up 9~24 months（mean,17.60±5.10 months）.The results showed that the wrist pain was improved in 22 patients with postoperative follow-up.The grip strength was improved with the degree of rotational activity（157.05±3.26）°,the radius of the ulcer（39.45±1.60）°,the wrist Joint flexion and extension（126.95±1.65）°.According to improved Mayo score：excellent in 14 cases,good in 6 cases,fair in 2 cases;excellent rate of 90.9%.Conclusion Wrist arthroscopy is a minimally invasive,effective and safe method for diagnosis and treatment of patients with TFCC injury.The follow-up effect is satisfactory and should be used as a routine diagnosis and treatment of ulcer joint pain.
出处
《实用骨科杂志》
2018年第2期112-116,共5页
Journal of Practical Orthopaedics
基金
四川省科技厅科研基金资助项目(13012)
关键词
腕关节镜
三角纤维软骨复合体
功能评定
wrist arthroscopy
triangular fiber cartilage complex
functional evaluation
