Ho P C, Law B K Y, Hung L K
Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, 5th floor, Prince of Wales Hospital, Hong Kong SAR, China.
Chir Main. 2006 Nov;25 Suppl 1:S221-30.
As an original technique developed by our department, the preliminary result of arthroscopic resection of volar wrist ganglion was first published in 2003. Since then, there were few reports in the literature concerning this new treatment method. The aim of the study is to evaluate the long-term outcome of this treatment technique. From August 1997 to April 2005, 21 volar wrist ganglia with average size of 2 cm (range 1-4 cm) were treated. The average age of patients was 48.6 (range 18-63). Thirteen ganglia had previous treatment including either aspiration or open excision. Seventy-one percent of the operations were performed under local anesthesia. Wrist arthrogram was performed in 9 cases. Seven cases showed origin from radiocarpal joint and all proceeded to arthroscopic resection successfully. Arthroscopically, 75% of ganglia arose from the interval between radioscaphocapitate and long radiolunate ligament, and 25% from the interval between long radiolunate and short radiolunate ligament. Sixteen of the 21 ganglia could be excised by arthroscopic technique. The average follow up was 56 months (range 9-101 months). There were 2 recurrences. One was treated with repeated arthroscopic excision and the other by open excision. There was no impairment of wrist motion and function in all patients. No neurovascular complication was encountered. Arthroscopic resection was an effective treatment method for well-selected volar wrist ganglion arising from the radiocarpal joint in long run.
作为我们科室研发的一项原创技术,腕掌侧腱鞘囊肿关节镜切除术的初步结果于2003年首次发表。从那时起,关于这种新治疗方法的文献报道很少。本研究的目的是评估这种治疗技术的长期疗效。从1997年8月至2005年4月,对21例平均大小为2 cm(范围1 - 4 cm)的腕掌侧腱鞘囊肿进行了治疗。患者的平均年龄为48.6岁(范围18 - 63岁)。13个腱鞘囊肿曾接受过包括抽吸或开放切除在内的治疗。71%的手术在局部麻醉下进行。9例患者进行了腕关节造影。7例显示起源于桡腕关节,均成功进行了关节镜切除。在关节镜下,75%的腱鞘囊肿起源于桡舟头关节和桡月长韧带之间的间隙,25%起源于桡月长韧带和桡月短韧带之间的间隙。21个腱鞘囊肿中有16个可通过关节镜技术切除。平均随访56个月(范围9 - 101个月)。有2例复发。1例经重复关节镜切除治疗,另1例经开放切除治疗。所有患者的腕关节活动和功能均未受损。未发生神经血管并发症。从长远来看,关节镜切除是治疗精心选择的起源于桡腕关节的腕掌侧腱鞘囊肿的一种有效治疗方法。