Finsen Vilhjalmur, Borchgrevink Grethe Elisabeth
Department of Orthopaedic Surgery, St. Olav's University Hospital, Trondheim, Norway , Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
Hand Surg. 2013;18(3):337-41. doi: 10.1142/S0218810413500366.
We reviewed 17 patients 64 (range 29-123) months after dorsal radioscaphoid capsulodesis for scapholunate dissociation. Mean loss of key pinch was 13%, grip strength 18%, wrist flexion 22% (p < 0.001), and total wrist ROM 17% (p < 0.005). VAS (0 = best; 100 = worst) was 30(±28) for pain, 43(±30) for function, and 33(±33) for general satisfaction with the outcome. Mean Quick-DASH and PRWE scores were 27 and 34, respectively. The mean scapholunate gap was 3.5 mm before surgery, 1.9 mm after surgery, and 3.3 mm at review. The corresponding scapholunate angles were 63°, 46°, and 70°, respectively. The mean radioscaphoid angle with the wrist maximally flexed was 84° (69-99) for the patients and was 91° (77-103) in ten wrists of volunteers. Six patients had changed their jobs because of the wrist. Three patients stated that they would not have consented to operation if they had known the outcome in advance. Radioscaphoid capsulodesis does not prevent volar flexion of the scaphoid.
我们对17例因舟月关节分离接受背侧桡舟关节囊固定术的患者进行了64个月(范围29 - 123个月)的随访。捏力平均丧失13%,握力丧失18%,腕关节屈曲丧失22%(p < 0.001),腕关节总活动度丧失17%(p < 0.005)。视觉模拟评分(VAS,0分表示最佳;100分表示最差):疼痛为30(±28)分,功能为43(±30)分,对结果的总体满意度为33(±33)分。Quick - DASH和PRWE平均得分分别为27分和34分。术前舟月间隙平均为3.5mm,术后为1.9mm,随访时为3.3mm。相应的舟月角分别为63°、46°和70°。患者腕关节最大屈曲时桡舟角平均为84°(69 - 99),志愿者十只腕关节的该角度为91°(77 - 103)。6例患者因腕关节问题更换了工作。3例患者表示,如果他们事先知道结果,就不会同意手术。桡舟关节囊固定术并不能防止舟骨掌屈。