Farr Sebastian, Zechmann Ulrike, Ganger Rudolf, Girsch Werner
Department of Pediatric Orthopaedics, Deformity Correction and Adult Foot and Ankle Surgery, Orthopaedic Hospital Speising, Speisingerstrasse 109, 1130, Vienna, Austria,
Int Orthop. 2015 Aug;39(8):1571-7. doi: 10.1007/s00264-015-2795-6. Epub 2015 Apr 28.
The purpose of this study was to report our preliminary results after arthroscopically-assisted repair of peripheral triangular fibrocartilage complex (TFCC) tears in adolescent patients.
All children and adolescents who underwent arthroscopically-assisted repair of a Palmer 1B tear were identified and prospectively evaluated after a mean follow-up of 1.3 years. The postoperative assessment included documentation of clinical parameters, pain score (visual analogue scale, VAS), grip strength and completion of validated outcome scores (Modified Mayo Wrist Score, MMWS; Disabilities of the Arm, Shoulder and Hand Inventory, DASH). A total of 12 patients (four males, eight females) with a mean age of 16.3 years at the time of surgery were evaluated.
The mean VAS decreased significantly from 7.0 to 1.7 after the procedure. We observed a significant increase of the MMWS after surgery; however, MMWS was still significantly lower at final follow-up when compared to the contralateral side. A mean postoperative DASH score of 16 indicated an excellent outcome after the procedure. DASH Sports and Work Modules showed fair and good overall outcomes in the short-term, respectively. Grip strength averaged 86 % of the contralateral side at final follow-up, with no significant difference being found between both sides.
Arthroscopically-assisted repair of peripheral TFCC tears in adolescents provided predictable pain relief and markedly improved functional outcome scores. Concomitant pathologies may have to be addressed at the same time to eventually achieve a satisfactory outcome. Sports participation, however, may be compromised in the short-term and should therefore be resumed six months postoperatively.
本研究旨在报告青少年患者经关节镜辅助修复桡骨远端三角纤维软骨复合体(TFCC)撕裂后的初步结果。
确定所有接受关节镜辅助修复Palmer 1B型撕裂的儿童和青少年,并在平均随访1.3年后进行前瞻性评估。术后评估包括记录临床参数、疼痛评分(视觉模拟量表,VAS)、握力以及完成经过验证的疗效评分(改良梅奥腕关节评分,MMWS;手臂、肩部和手部功能障碍量表,DASH)。共评估了12例患者(4例男性,8例女性),手术时平均年龄为16.3岁。
术后VAS平均评分从7.0显著降至1.7。我们观察到术后MMWS显著提高;然而,与对侧相比,末次随访时MMWS仍显著较低。术后DASH平均评分为16,表明手术效果极佳。DASH运动和工作模块在短期内分别显示出中等和良好的总体效果。末次随访时握力平均为对侧的86%,两侧之间未发现显著差异。
青少年经关节镜辅助修复桡骨远端TFCC撕裂可有效缓解疼痛,并显著改善功能评分。可能需要同时处理合并的病变以最终获得满意的结果。然而,短期内运动参与可能会受到影响,因此应在术后6个月恢复运动。