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[舟月关节分离:背侧关节囊固定术治疗]

[Scapholunate dissociation: treatment by dorsal capsulodesis].

作者信息

Busse F, Felderhoff J, Krimmer H, Lanz U

机构信息

Klinik für Handchirurgie, Abteilung I, Bad Neustadt/Saale, Germany.

出版信息

Handchir Mikrochir Plast Chir. 2002 May;34(3):173-81. doi: 10.1055/s-2002-33690.

Abstract

Between December 1994 and December 1996, 26 patients with a scapholunate ligament injury (three with SLD 1. degrees, 16 with SLD 2. degrees and 7 with SLD 3. degrees ) underwent an operation for dorsal capsulodesis in the Klinik für Handchirurgie, Bad Neustadt/Saale. Mean follow-up was 24 months (16 to 37 months). Follow-up criteria were range of motion, grip strength, pain relief, and X-ray findings. Clinical outcome was evaluated using a personal questionnaire, the DASH- and a modified Cooney-Score. Although significant reduction of joint mobility compared to the opposite site was found in all cases (E/F 32 %, U/R 19 %), the reduction of pain was 30 %. Grip-strength was not altered. Thus, 86 % of the patients were satisfied with the result obtained. On X-ray, the scapholunate angle was raised in the SLD 3. degrees -group by 12 degrees postoperatively; in the group with dynamic instability, X-ray findings were normal. Overall, 19 % (5/26) needed further operations due to persistent pain.

摘要

1994年12月至1996年12月期间,26例舟月韧带损伤患者(3例为1度舟月韧带损伤,16例为2度,7例为3度)在巴特新施塔特/萨勒的手外科诊所接受了背侧关节囊固定术。平均随访时间为24个月(16至37个月)。随访标准包括活动范围、握力、疼痛缓解情况及X线检查结果。使用个人问卷、DASH量表和改良的库尼评分评估临床结果。尽管所有病例与对侧相比关节活动度均有显著降低(腕关节屈伸32%,尺桡关节19%),但疼痛减轻了30%。握力未改变。因此,86%的患者对所取得的结果满意。在X线检查中,3度舟月韧带损伤组术后舟月角升高了12度;在动态不稳定组,X线检查结果正常。总体而言,19%(5/26)的患者因持续疼痛需要进一步手术。

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