Hattori Tatsuya, Tsunoda Kenji, Watanabe Kentaro, Nakao Etsuhiro, Hirata Hitoshi, Nakamura Ryogo
Department of Hand Surgery, Graduate School of Nagoya University, Nagoya, Japan.
Arthroscopy. 2006 Aug;22(8):850-4. doi: 10.1016/j.arthro.2006.04.099.
We evaluated the clinical efficacy of arthroscopic mobilization of the wrist for release of persistent traumatic contracture.
We retrospectively reviewed 11 consecutive patients who had undergone arthroscopic mobilization after trauma. Patients included 9 men and 2 women who ranged in age from 16 to 65 years (mean, 40 years). Injuries causing contracture included 8 fractures of the distal radius, 1 Galeazzi fracture, 1 perilunate dislocation, and 1 carpal bone contusion. A single radiocarpal septum extended from the proximal fibrocartilage of the scapholunate ligament to the midradial ridge in all but 1 patient, in whom multiple fibrous bands bridged the radiocarpal joint.
Arthroscopy disclosed 3 types of radiocarpal septum-a single fibromembranous structure that completely divided the joint (type A) in 9 cases, a membranous structure with a fenestration that partially divided the joint (type B) in 1 case, and multiple bands that completely divided the joint (type C); the latter situation occurred in the last patient described earlier. Preoperatively, the arc of motion averaged 76 degrees compared with an average of 98 degrees . Postoperatively, a 22 degrees increase was noted.
Arthroscopic release of a radiocarpal septum was effective in improving range of wrist motion in patients with this finding.
Level IV, therapeutic case series.
我们评估了关节镜下腕关节松解术治疗持续性创伤性挛缩的临床疗效。
我们回顾性分析了11例创伤后接受关节镜下松解术的连续患者。患者包括9名男性和2名女性，年龄在16至65岁之间（平均40岁）。导致挛缩的损伤包括8例桡骨远端骨折、1例盖氏骨折、1例月骨周围脱位和1例腕骨挫伤。除1例患者外，所有患者均有一条单一的桡腕间隔从舟月韧带的近端纤维软骨延伸至桡骨中嵴，该例患者有多个纤维束横跨桡腕关节。
关节镜检查发现3种类型的桡腕间隔——9例为单一纤维膜结构完全分隔关节（A型），1例为有开窗的膜性结构部分分隔关节（B型），以及多条纤维束完全分隔关节（C型）；后一种情况发生在上述最后一名患者中。术前，平均活动弧度为76度，术后平均为98度。术后活动弧度增加了22度。
关节镜下松解桡腕间隔对改善有此表现患者的腕关节活动范围有效。
IV级，治疗性病例系列。
