Pin P G, Young V L, Gilula L A, Weeks P M
Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, St. Louis, Mo.
J Hand Surg Am. 1989 Jan;14(1):77-83. doi: 10.1016/0363-5023(89)90062-2.
Treatment of chronic disruptions of the lunotriquetral (LT) ligament is not well-defined. Eleven patients treated by LT fusion with use of a compression screw are reported. The injury frequently resulted from hyperextension of the wrist. Pain on the ulnar side of the wrist, limited motion, and tenderness over the LT joint exacerbated by ballottement were present. Standard radiographs were normal. Arthrography showed the ligamentous tear in all cases. After operation, immobilization was continued until fusion was apparent radiographically. Fusion was achieved in all cases between 2 and 5 months. Four patients were free of pain, four patients had pain only at the extremes of motion, and three patients had persistent pain. Mean wrist motion was as follows (preoperative/postoperative): flexion (53 degrees/45 degrees), extension (60 degrees/49 degrees), radial deviation (17 degrees/21 degrees), and ulnar deviation (25 degrees/18 degrees). Maximum grip strength as a percentage of the uninjured side was 73% preoperatively and 59% postoperatively. LT tears can exist de novo or as part of the ulnar impaction syndrome; a method for differentiation is presented.
月三角韧带慢性损伤的治疗方法尚不明确。本文报告了11例采用加压螺钉进行月三角融合术治疗的患者。损伤常因腕关节过度伸展所致。患者存在腕部尺侧疼痛、活动受限，以及月三角关节处压痛（通过冲击试验可加重）。标准X线片结果正常。关节造影显示所有病例均有韧带撕裂。术后持续固定，直至影像学显示融合明显。所有病例均在2至5个月内实现融合。4例患者无痛，4例患者仅在活动极限时疼痛，3例患者持续疼痛。腕关节平均活动度如下（术前/术后）：屈曲（53度/45度）、伸展（60度/49度）、桡侧偏斜（17度/21度）和尺侧偏斜（25度/18度）。术前患侧最大握力占健侧的百分比为73%，术后为59%。月三角韧带撕裂可原发存在，也可作为尺骨撞击综合征的一部分；本文介绍了一种鉴别方法。
