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MRI 随访游离肌腱移植重建拇指尺侧副韧带术后。

MRI follow-up after free tendon graft reconstruction of the thumb ulnar collateral ligament.

机构信息

Department of Radiology, Helsinki University Hospital, PL 900, 00029 HUS, Helsinki, Finland.

出版信息

Skeletal Radiol. 2010 Nov;39(11):1081-6. doi: 10.1007/s00256-010-0923-3. Epub 2010 May 7.

Abstract

OBJECTIVE

Our aim was to analyse whether MRI is useful in the follow-up of reconstruction of the ulnar collateral ligament (UCL) of the metacarpophalangeal joint of the thumb, to describe normal postoperative findings, and to evaluate different MR sequences.

MATERIAL AND METHODS

Our study material consists of 10 patients who, because of a chronic rupture of the ulnar collateral ligament of the thumb, had been operatively treated using a free tendon graft. The patients were, in addition to the clinical examination and radiographs, also imaged using MRI both pre- and postoperatively. The postoperative MRI controls, undertaken at 2, 12 and 24 months were analysed without knowledge of the clinical or radiographic findings.

RESULTS

The reconstructed UCL was well visualised on MRI. One graft rupture was diagnosed on MRI and was later operatively confirmed. No increase in osteoarthritis of the metacarpophalangeal (MP) joint of the thumb was seen during the follow-up. The single most informative MR sequence was T2TSE in the coronal plane.

CONCLUSION

Magnetic resonance imaging may provide a clinically valuable means of assessing graft integrity in patients with suspected postoperative graft failure after UCL reconstruction, although we do not consider MRI necessary in the routine follow-up of patients with an uneventful recovery.

摘要

目的

本研究旨在分析 MRI 在拇指掌指关节尺侧副韧带(UCL)重建后的随访中的作用,描述正常的术后发现,并评估不同的 MR 序列。

材料与方法

我们的研究对象为 10 例因慢性 UCL 撕裂而接受游离肌腱移植手术治疗的患者。除了临床检查和 X 线片外,所有患者在术前和术后均接受 MRI 成像。对术后 2、12 和 24 个月的 MRI 检查结果进行分析,分析时不了解临床或放射学结果。

结果

重建后的 UCL 在 MRI 上清晰可见。1 例患者 MRI 诊断为移植物撕裂,随后手术证实。在随访期间,拇指掌指关节(MP)无骨关节炎加重。最具信息性的单一 MR 序列是冠状面 T2TSE。

结论

尽管我们认为对于恢复顺利的患者,MRI 在常规随访中并非必需,但 MRI 可能为疑似 UCL 重建后术后移植物失败的患者提供一种有临床价值的评估移植物完整性的方法。

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