Blanco Roque H, Blanco Fernando R
Department of Hand Surgery, Clínica Reina Fabiola, Universidad Católica de Córdoba, Córdoba, Argentina.
J Hand Surg Am. 2012 Nov;37(11):2221-5. doi: 10.1016/j.jhsa.2012.07.023. Epub 2012 Sep 18.
To determine the long-term effect of distal radius osteotomy without modifying the radial length or inclination for Kienböck disease.
Over 9 years, 14 patients underwent osteotomy of the distal radius without altering radial length or inclination. A total of 11 of these patients were available for follow-up after 10 or more years. We assessed pain, range of wrist motion, and grip strength preoperatively and postoperatively in all cases, as well as preoperative and postoperative posteroanterior and lateral x-rays.
The osteotomy healed in all cases. All 11 patients had decreased pain and showed improvement in wrist motion and grip strength. Radiographically, there were no measurable changes in ulnar variance and there was minimal loss of carpal height. In some patients, the lunate showed increased sclerosis or fragmentation.
An osteotomy of the distal radius without altering radial length or inclination was effective in decreasing pain and improving grip strength and wrist motion regardless of ulnar variance.
确定在不改变桡骨长度或倾斜度的情况下，桡骨远端截骨术治疗月骨无菌性坏死的长期疗效。
在9年多的时间里，14例患者接受了桡骨远端截骨术，未改变桡骨长度或倾斜度。其中11例患者在10年或更长时间后可供随访。我们评估了所有病例术前和术后的疼痛、腕关节活动范围和握力，以及术前和术后的正位和侧位X线片。
所有病例截骨均愈合。11例患者疼痛均减轻，腕关节活动和握力均有改善。影像学上，尺骨变异无明显变化，腕骨高度仅有轻微丢失。部分患者月骨硬化或碎裂加重。
不改变桡骨长度或倾斜度的桡骨远端截骨术能有效减轻疼痛，改善握力和腕关节活动，与尺骨变异无关。
