[腕骨塌陷的治疗：近排腕骨切除术还是有限的腕中关节融合术？一项比较研究]

[The treatment of carpal collapse: proximal row carpectomy or limited midcarpal arthrodesis? A comparative study].

作者信息

Lukas B, Herter F, Englert A, Bäcker K

机构信息

Zentrum für Handchirurgie, Mikrochirurgie, Plastische Chirurgie, Orthopädische Klinik München-Harlaching, Munich.

出版信息

Handchir Mikrochir Plast Chir. 2003 Oct;35(5):304-9. doi: 10.1055/s-2003-43119.

DOI:10.1055/s-2003-43119

PMID:14577045

Abstract

Between July 2000 and February 2002, 26 wrists were treated because of SLAC, SNAC and radiocarpal arthrosis after fracture of the distal radius. In 14 cases proximal row carpectomy (PRC) and in twelve cases limited midcarpal arthrodesis (LWF) was performed. Follow-up was after a mean time of 16.8 (PRC) and 13.7 months (LWF) on ten wrists each. There was one complication in the PRC group and two in the LWF group. In all cases significant reduction of extension/flexion was observed with a mean range of motion of 69 degrees (PRC) and 71 degrees (LWF). The reduction of pain postoperatively was almost identical in both groups. Comparing grip-strength to the unoperated hand, we measured 26 compared to 39 kg in the PRC group and 28 compared to 46 kg in the LWF group, respectively. The DASH-score for the LWF group was 30 points and therefore better than the 36 points for the PRC group.

摘要

2000年7月至2002年2月期间，对26例因桡骨远端骨折后出现舟月关节塌陷性骨关节炎（SLAC）、舟头关节塌陷性骨关节炎（SNAC）和桡腕关节骨关节炎而接受治疗的手腕进行了研究。其中14例行近排腕骨切除术（PRC），12例行有限的腕中关节融合术（LWF）。每组各对10例手腕进行随访，平均随访时间分别为PRC组16.8个月、LWF组13.7个月。PRC组出现1例并发症，LWF组出现2例并发症。所有病例均观察到屈伸活动度显著降低，PRC组平均活动度为69度，LWF组为71度。两组术后疼痛减轻情况几乎相同。与未手术侧手相比，PRC组握力由39千克降至26千克，LWF组握力由46千克降至28千克。LWF组的DASH评分是30分，因此优于PRC组的36分。