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关节镜辅助下关节内骨折复位及桡骨远端软组织处理

Arthroscopically-assisted reduction of intra-articular fractures and soft tissue management of distal radius.

作者信息

Shih J T, Lee H M, Hou Y T, Tan C M

机构信息

Department of Orthopaedic Surgery, Armed Forces Taoyuan General Hospital, Taiwan, ROC.

出版信息

Hand Surg. 2001 Dec;6(2):127-35. doi: 10.1142/s021881040100059x.

Abstract

Arthroscopy was used to help to reduce intra-articular fractures of the distal radius and treat soft tissue injuries in 33 acute cases. The fractures were treated by reduction under arthroscopic control and percutaneous fixation either with or without external fixation. The triangular fibrocartilage complex (TFCC) was torn in 18 of 33 patients (54%). All tears were peripheral and were repaired with arthroscopic procedures. Scapholunate (SL) ligament injuries prevailed in six (18%) patients; most of them exhibited instability in the SL joint. They received SL ligament debrided and transfixed with K-wires. Four (12%) of the patients suffered lunotriquetral (LT) ligament injuries; three of them also received transfixation with K-wires. Six (18%) of the patients exhibited chondral fractures. All fractures healed without measurable incongruity of joint surface and at follow-up (24 to 36 months), 11 patients displayed excellent results and 22 patients displayed good results according to the Mayo modified wrist score.

摘要

关节镜用于协助复位33例急性桡骨远端关节内骨折并治疗软组织损伤。骨折通过关节镜控制下复位及经皮固定治疗,可采用或不采用外固定。33例患者中有18例(54%)三角纤维软骨复合体(TFCC)撕裂。所有撕裂均为周边性,通过关节镜手术修复。舟月(SL)韧带损伤在6例(18%)患者中占主导;其中大多数在SL关节表现出不稳定。他们接受了SL韧带清创并用克氏针固定。4例(12%)患者遭受月三角(LT)韧带损伤;其中3例也接受了克氏针固定。6例(18%)患者出现软骨骨折。所有骨折均愈合,关节面无明显不平整,随访(24至36个月)时,根据梅奥改良腕关节评分,11例患者结果为优,22例患者结果为良。

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