De Smet Luc, Robijns Filip, Degreef Ilse
Department of Orthopaedic Surgery, U.Z. Pellenberg, Lubbeek, Pellenberg, Belgium.
Scand J Plast Reconstr Surg Hand Surg. 2006;40(5):302-6. doi: 10.1080/02844310600869779.
Fifty-one patients who had had proximal row carpectomy between 1992 and 2002 with a minimum follow-up of one year were followed up clinically and radiologically retrospectively. Their diagnoses included Kienböck disease (n=21), avascular necrosis of the scaphoid (n=4), nonunion of the scaphoid with osteoarthritis (n=9), and scapholunate advanced collapse (n=17). The mean follow-up was 5 years, 8 months. The mean "disabilities of the arm, shoulder and hand" (DASH) score was 18. The mean patient-rated wrist evaluation (PRWE) score list was 25% of maximum disability for the function and pain score. Thirty-four patients (87%) were able to return to work a mean of six months after operation (range 3 weeks - 35 months). Nine patients (11%) required arthrodesis of the wrist and are considered as failures. Mean flexion of the wrist was 66%, extension 73%, radial deviation 74%, ulnar deviation 76%, and grip force 70% of the opposite side. Excision of the proximal row provided predictable and durable pain relief, restored functional movement and grip strength, and allowed returned to gainful employment in most of the patients.
对1992年至2002年间接受近排腕骨切除术且至少随访1年的51例患者进行临床和影像学回顾性随访。他们的诊断包括月骨缺血性坏死（n = 21）、舟骨缺血性坏死（n = 4）、舟骨不愈合伴骨关节炎（n = 9）以及舟月骨进行性塌陷（n = 17）。平均随访时间为5年8个月。平均“上肢、肩部和手部功能障碍”（DASH）评分为18分。患者自评腕关节评估（PRWE）评分列表显示，功能和疼痛评分的最大残疾程度为25%。34例患者（87%）术后平均6个月（范围3周 - 35个月）能够重返工作岗位。9例患者（11%）需要进行腕关节融合术，被视为手术失败。患侧腕关节平均屈曲度为对侧的66%，伸展度为74%，桡偏度为74%，尺偏度为76%，握力为70%。切除近排腕骨可提供可预测且持久的疼痛缓解，恢复功能活动和握力，并使大多数患者能够重返有收益的工作岗位。
