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舟状骨-大多角骨-小多角骨关节融合术(三舟关节融合术)

[Scapho-trapezio-trapezoid arthrodesis (triscaphe arthrodesis)].

作者信息

Meier R, Prommersberger K-J, Krimmer H

机构信息

Klinik für Handchirurgie, Bad Neustadt/Saale.

出版信息

Handchir Mikrochir Plast Chir. 2003 Oct;35(5):323-7. doi: 10.1055/s-2003-43111.

Abstract

BACKGROUND

Scapho-trapezio-trapezoid (STT)/triscaphe fusion is used to stabilize the radial column of the wrist. However the reported results are controversial.

MATERIAL AND METHODS

111 patients were treated with STT fusion from 1992 to 1997. Indications were chronic dissociation of the scapholunate joint (n = 15), idiopathic arthrosis of the scaphotrapeziotrapezoid joint (n = 11), Kienböck's disease in advanced stage (n = 84) and dislocation of the trapezium (n = 1). This study reviews the results after an average follow-up period of four years (range, two to eight years).

RESULTS

Patients showed an average wrist motion (ROM) in extension and flexion of 81 % of the preoperative range and in radial and ulnar deviation of 68 % of the preoperative range. Preoperative pain values (VAS) were reduced 76 % (non-stress) and 55 % (stress). The average grip strength improved to 65 % of the contra-lateral side. Good results were reached according to the modified Mayo wrist score with a score of 66 points (71 points in arthritis of the STT joint; 62 points in Kienböck's disease, 60 points in SL-dissociation). The patients described low disability in the DASH scores, with an average of 27 points.

CONCLUSIONS

Our data show that STT fusion is reliable and effective for treatment and pain relief and offers reasonable functional results in the above mentioned indications.

摘要

背景

舟-大多角-小多角(STT)/三舟融合术用于稳定腕部桡侧柱。然而,报道的结果存在争议。

材料与方法

1992年至1997年,111例患者接受了STT融合术。适应证包括舟月关节慢性分离(n = 15)、舟大多角小多角关节特发性关节炎(n = 11)、晚期月骨缺血性坏死(n = 84)和大多角骨脱位(n = 1)。本研究回顾了平均四年(范围为两年至八年)的随访结果。

结果

患者腕关节屈伸平均活动度(ROM)为术前范围的81%,桡尺偏平均活动度为术前范围的68%。术前疼痛值(VAS)在非应力状态下降低了76%,在应力状态下降低了55%。平均握力提高到对侧的65%。根据改良的梅奥腕关节评分,结果良好,评分为66分(STT关节关节炎为71分;月骨缺血性坏死为62分,舟月分离为60分)。患者在DASH评分中显示出低残疾程度,平均为27分。

结论

我们的数据表明,STT融合术在上述适应证中治疗可靠、能有效缓解疼痛并提供合理功能结果。

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