Mathoulin C, Messina J
Institut de la main, clinique Jouvenet, Paris, France.
Chir Main. 2010 Apr;29(2):72-7. doi: 10.1016/j.main.2009.12.002. Epub 2010 Jan 20.
Scapholunate ligament tears give chronic instability leading in SLAC. The wrist arthroscopy allows to see the lesions, even in early stage, and to treat them, with a simple K-Wires fixation in acute cases. The patients were operated on in outpatient basis with tourniquet and local general anaesthesia. In acute cases, the scapholunate dissociation was reduced by external and internal manoeuvres. The fixation was done with two pins under arthroscopic and fluoroscopic controls. We report a series of 66 acute cases (less than 45 days after trauma). Forty-four patients were males and 22 females. The average age was 39 years old (range 19-46). Our average follow-up in acute cases was 36 months (range 14-61). According the "Mayo Wrist Score", we obtained 92 % of good or excellent results. The wrist arthroscopy is the best technique for early diagnosis, guarantee of best functional results.
舟月韧带撕裂会导致慢性不稳定,进而发展为舟月关节塌陷(SLAC)。腕关节镜检查即使在早期也能发现病变,并对其进行治疗,急性病例采用简单的克氏针固定。患者在门诊使用止血带和局部全身麻醉进行手术。在急性病例中,通过内外手法复位舟月关节分离。在关节镜和透视控制下用两根钢针进行固定。我们报告了一系列66例急性病例(创伤后不到45天)。44例为男性,22例为女性。平均年龄为39岁(范围19 - 46岁)。我们对急性病例的平均随访时间为36个月(范围14 - 61个月)。根据“梅奥腕关节评分”,我们获得了92%的良好或优秀结果。腕关节镜检查是早期诊断的最佳技术,能保证最佳功能结果。