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腕舟大多角小多角骨关节炎的大多角骨切除术及韧带重建肌腱植入术

Trapeziectomy and ligament reconstruction tendon interposition for isolated scaphotrapeziotrapezoid osteoarthritis of the wrist.

作者信息

Langenhan R, Hohendorff B, Probst A

机构信息

Hegau-Bodensee-Klinikum Singen, Klinik für Orthopädie, Unfall- und Handchirurgie, Virchowstrasse, Singen, Germany

Elbe Kliniken Stade Buxtehude, Abteilung für Hand-, Ästhetische und Plastische Chirurgie, Stade, Germany.

出版信息

J Hand Surg Eur Vol. 2014 Oct;39(8):833-7. doi: 10.1177/1753193413514500. Epub 2013 Dec 12.

Abstract

Isolated osteoarthritis of the scaphotrapeziotrapezoid joint is rather rare compared with thumb trapeziometacarpal osteoarthritis. The aim of this retrospective study was to evaluate the outcome of 15 consecutive patients treated with trapeziectomy/ligament reconstruction tendon interposition for isolated scaphotrapeziotrapezoid osteoarthritis of the wrist. After a mean follow-up of 54 months, 14 patients (15 wrists) were available for clinical and radiological examination. The median pain intensity was 0 on a 0-10 visual analogue scale, both at rest and with activity, mean grip strength averaged 24 kg, pinch strength 5 kg. The disabilities of the arm, shoulder and hand (DASH) score was 16, and a modified Mayo Wrist Score 84. Correlation between the degree of scaphotrapezoid osteoarthritis and pain at rest, pain with activity, and DASH score was not significant. The findings from our study suggest that trapeziectomy/ligament reconstruction tendon interposition is an effective procedure for treating isolated scaphotrapeziotrapezoid osteoarthritis, and that additional partial trapezoid excision is not necessary.

摘要

与拇指腕掌关节骨关节炎相比,舟大多角小多角关节孤立性骨关节炎相当罕见。本回顾性研究的目的是评估连续15例接受大多角骨切除/韧带重建肌腱植入术治疗的腕部舟大多角小多角关节孤立性骨关节炎患者的疗效。平均随访54个月后,14例患者(15个腕关节)接受了临床和影像学检查。静息及活动时疼痛强度的中位数在0-10视觉模拟量表上均为0,平均握力为24千克,捏力为5千克。上肢、肩部和手部功能障碍(DASH)评分为16分,改良梅奥腕关节评分为84分。舟大多角关节骨关节炎程度与静息疼痛、活动时疼痛及DASH评分之间的相关性不显著。我们的研究结果表明,大多角骨切除/韧带重建肌腱植入术是治疗舟大多角小多角关节孤立性骨关节炎的有效方法,无需额外进行部分小多角骨切除。

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