目的评价腕关节部分融合术治疗月骨缺血性坏死的临床疗效。方法对12例月骨缺血性坏死的患者，按Lichnnan分期，Ⅱ期7例，Ⅲ期5例，诊断至手术时间为7—40个月，平均20个月。术前所有患者均有不同程度的腕部疼痛、无力感，腕背侧轻度肿...目的评价腕关节部分融合术治疗月骨缺血性坏死的临床疗效。方法对12例月骨缺血性坏死的患者，按Lichnnan分期，Ⅱ期7例，Ⅲ期5例，诊断至手术时间为7—40个月，平均20个月。术前所有患者均有不同程度的腕部疼痛、无力感，腕背侧轻度肿胀、压痛，活动功能障碍和握力减弱等临床表现，x线片显示：月骨不同程度囊性变、密度增高或边缘硬化。采用腕关节部分融合＋钢板内固定术，术后3个月拆除石膏后行功能锻炼。结果术后随访时间为6—18个月，平均12个月。所有患者伤口均Ⅰ期愈合，1例腕背部切口瘢痕增生。术后腕部疼痛、无力症状较术前明显好转，半年后随访X线片显示月骨形态正常、坏死区消失6例，明显缩小3例，部分缩小3例；舟-月-头状骨间隙消失，见骨性融合，桡腕关节间隙正常。腕关节疼痛程度采用视觉模拟评分法（visual analog scale，VAS）评分、活动度、握力均较术前改善，腕关节功能按Kriinmer评分：优5例，良5例，可2例，优良率达83．3％。结论腕关节部分融合术治疗月骨缺血性坏死效果确切，保留腕关节大部分功能，是一种较好的治疗方法。展开更多
Lateral closing wedge osteotomy is a treatment for Kienbock’s disease. It is one of the most frequently used treatment options, which has been reported with relatively good long-term results. However, the results abo...Lateral closing wedge osteotomy is a treatment for Kienbock’s disease. It is one of the most frequently used treatment options, which has been reported with relatively good long-term results. However, the results about the treatment are still controversial in some literatures and some key mechanisms are still not clear. The objective of the cur-rent study was to study the biomedical mechanism of the treatment. A finite element model was developed based on the geometry of carpal bones. Various situations in-cluding inclination angle changes by cutting the radial with 0?, 5?, 10? and 15? osteot-omy angles were studied. The effectiveness of the treatment was also studied for the carpal structure with abnormal positions of the lunate bone. The results show that the effectiveness of the stress reduction with the angle depends on many situations such as the initial morphology of the carpal structure.展开更多
文摘目的评价腕关节部分融合术治疗月骨缺血性坏死的临床疗效。方法对12例月骨缺血性坏死的患者，按Lichnnan分期，Ⅱ期7例，Ⅲ期5例，诊断至手术时间为7—40个月，平均20个月。术前所有患者均有不同程度的腕部疼痛、无力感，腕背侧轻度肿胀、压痛，活动功能障碍和握力减弱等临床表现，x线片显示：月骨不同程度囊性变、密度增高或边缘硬化。采用腕关节部分融合＋钢板内固定术，术后3个月拆除石膏后行功能锻炼。结果术后随访时间为6—18个月，平均12个月。所有患者伤口均Ⅰ期愈合，1例腕背部切口瘢痕增生。术后腕部疼痛、无力症状较术前明显好转，半年后随访X线片显示月骨形态正常、坏死区消失6例，明显缩小3例，部分缩小3例；舟-月-头状骨间隙消失，见骨性融合，桡腕关节间隙正常。腕关节疼痛程度采用视觉模拟评分法（visual analog scale，VAS）评分、活动度、握力均较术前改善，腕关节功能按Kriinmer评分：优5例，良5例，可2例，优良率达83．3％。结论腕关节部分融合术治疗月骨缺血性坏死效果确切，保留腕关节大部分功能，是一种较好的治疗方法。
文摘Lateral closing wedge osteotomy is a treatment for Kienbock’s disease. It is one of the most frequently used treatment options, which has been reported with relatively good long-term results. However, the results about the treatment are still controversial in some literatures and some key mechanisms are still not clear. The objective of the cur-rent study was to study the biomedical mechanism of the treatment. A finite element model was developed based on the geometry of carpal bones. Various situations in-cluding inclination angle changes by cutting the radial with 0?, 5?, 10? and 15? osteot-omy angles were studied. The effectiveness of the treatment was also studied for the carpal structure with abnormal positions of the lunate bone. The results show that the effectiveness of the stress reduction with the angle depends on many situations such as the initial morphology of the carpal structure.
