Kwon B C, Choi S-J, Shin J, Baek G H
Department of Orthopaedic Surgery, Hallym University Sacred Heart Hospital, Dongan-gu, Gyeonggi-do, Republic of Korea.
J Bone Joint Surg Br. 2009 Dec;91(12):1601-6. doi: 10.1302/0301-620X.91B12.22335.
Advanced osteoarthritis of the wrist or the distal articulation of the lunate with the capitate has traditionally been treated surgically by arthrodesis. In order to maintain movement, we performed proximal row carpectomy with capsular interposition arthroplasty as an alternative to arthrodesis in eight patients with advanced arthritis and retrospectively reviewed their clinical and radiographic outcomes after a mean follow-up of 41 months (13 to 53). The visual analogue scale (VAS) for pain at its worst and at rest, and the patient-rated wrist evaluation score improved significantly after surgery, whereas ranges of movement and grip strength were maintained at the pre-operative levels. Progression of arthritis in the radiocapitate joint was observed in three patients, but their outcomes were not significantly different from those without progression of arthritis. Proximal row carpectomy with capsular interposition arthroplasty is a reasonable option for the treatment of patients with advanced arthritis of the wrist.
传统上，腕关节晚期骨关节炎或月骨与头状骨的远侧关节一直通过关节融合术进行手术治疗。为了保留活动度，我们对8例晚期关节炎患者采用了带关节囊置入的近排腕骨切除术作为关节融合术的替代方法，并在平均随访41个月（13至53个月）后回顾性分析了他们的临床和影像学结果。术后，疼痛最严重时和静息时的视觉模拟量表（VAS）评分以及患者自评的腕关节评估得分均显著改善，而活动范围和握力维持在术前水平。3例患者出现了桡头关节关节炎进展，但其结果与未出现关节炎进展的患者相比无显著差异。带关节囊置入的近排腕骨切除术是治疗腕关节晚期关节炎患者的合理选择。
