Cižmář Igor, Ira Daniel, Višňa Petr, Pilný Jaroslav
Department of Trauma Surgery, University Hospital Olomouc, Olomouc, Czech Republic.
J Plast Surg Hand Surg. 2010 Nov;44(4-5):245-51. doi: 10.3109/02844311.2010.503089.
We present the clinical results of a study of chronic dynamic scapholunate (SL) dissociation treated by reconstruction of the dorsal SL ligament. A total of 35 patients who presented with chronic dynamic SL instability had the scapholunate ligament reconstructed with a tendon graft. Twenty-nine patients were available for follow-up evaluation after a minimal interval of 17 months (range 17-72). Patients' satisfaction was good in 26/29 patients. Postoperative range of movement was reduced in extension and improved for flexion and ulnar deviation. Mean wrist movements were 75% of those on the opposite side. Most patients had good pain relief and recovered their grip strength, and returned to their regular employment. Follow-up stress radiographs showed a reduction in the SL angle and gap. Reconstruction of the dorsal SL ligament provides sufficient restoration of stability, pain relief, and functional improvement of the wrist for patients with dynamic SL instability. Although the short-term results are encouraging, we think that this method should be verified by longer follow-up.
我们展示了一项通过重建舟月背侧韧带治疗慢性动力性舟月（SL）分离的临床研究结果。共有35例表现为慢性动力性SL不稳定的患者接受了肌腱移植重建舟月韧带。29例患者在至少17个月（范围17 - 72个月）的间隔后可进行随访评估。29例患者中有26例对治疗结果满意。术后伸展活动范围减小，屈曲和尺偏活动范围改善。平均腕关节活动度为对侧的75%。大多数患者疼痛缓解良好，握力恢复，并恢复了正常工作。随访应力X线片显示SL角和间隙减小。对于动力性SL不稳定患者，重建舟月背侧韧带可充分恢复腕关节稳定性、缓解疼痛并改善功能。尽管短期结果令人鼓舞，但我们认为该方法应通过更长时间的随访进行验证。
