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[关节镜下修复创伤性TFCC 1B级损伤——一项回顾性研究]

[Arthroscopic refixation of traumatic 1B-lesions of the TFCC--a retrospective study].

作者信息

Wedemeyer A, Wedemeyer C, Heckelei W, Preissler P

机构信息

Abteilung für orthopädische Chirurgie, Universität Duisburg-Essen.

出版信息

Handchir Mikrochir Plast Chir. 2009 Jun;41(3):135-40. doi: 10.1055/s-0029-1202842. Epub 2009 Mar 25.

Abstract

AIM

The aim of the study was to investigate the postoperative outcome of the arthroscopic sutures of traumatic 1B-lesions of triangular fibrocartilage complex (TFCC) tears.

METHODS

Thirty-six patients who underwent an arthroscopic repair of traumatic 1B-lesions of the TFCC without a dislocation of the ulnar styloid process were included in this study. The average age of the 18 male and 18 female patients was 43.8 (range: 22-70) years. In 16 cases, we operated the left and in 20 cases the right TFCC. On average, the follow-up examination was performed after 7.9 years (range: 3.2-14.3) years. Patients with revision operations or neurovascular pathology were excluded. The Mayo modified wrist score and the disability of arm, shoulder and hand (DASH) score were used to identify the outcome.

RESULTS

The Mayo modified wrist score was preoperatively 49.74+/-20.99 and postoperatively 82.43+/-15.89 (p<0.001). The DASH score was preoperatively 48.68+/-21.47 and postoperatively 24.1+/-19.81 (p<0.001). Only five patients demonstrated an isolated 1B-lesion of the TFCC and showed, likewise, significant improvements both regarding the DASH score and the Mayo modified wrist score (p<0.05). However, there was no significant difference to the patients with further wrist injuries (p>0.05).

CONCLUSION

The results of the current study suggest that 1B-lesions of the TFCC can be successfully repaired by arthroscopically assisted suture techniques. An isolated 1B-lesion of the TFCC is rather unusual.

摘要

目的

本研究旨在调查关节镜下缝合三角纤维软骨复合体(TFCC)创伤性1B级损伤的术后结果。

方法

本研究纳入了36例行关节镜修复TFCC创伤性1B级损伤且尺骨茎突未脱位的患者。18例男性和18例女性患者的平均年龄为43.8岁(范围:22 - 70岁)。16例手术操作的是左侧TFCC,20例是右侧TFCC。平均随访时间为7.9年(范围:3.2 - 14.3年)。排除接受翻修手术或有神经血管病变的患者。采用Mayo改良腕关节评分和上肢、肩部和手部功能障碍(DASH)评分来评估结果。

结果

Mayo改良腕关节评分术前为49.74±20.99,术后为82.43±15.89(p<0.001)。DASH评分术前为48.68±21.47,术后为24.1±19.81(p<0.001)。只有5例患者表现为孤立的TFCC 1B级损伤,同样在DASH评分和Mayo改良腕关节评分方面均有显著改善(p<0.05)。然而,与合并其他腕部损伤的患者相比,差异无统计学意义(p>0.05)。

结论

本研究结果表明,TFCC的1B级损伤可通过关节镜辅助缝合技术成功修复。孤立的TFCC 1B级损伤较为少见。

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