桡骨缩短截骨术治疗 Lichtman IIIA 期月骨无菌性坏死。
Radial shortening osteotomy for treatment of Lichtman Stage IIIA Kienböck disease.
作者信息
Luegmair M, Goehtz F, Kalb K, Cip J, van Schoonhoven J
机构信息
1 Department of Orthopaedic Surgery, Medical University of Innsbruck, Zams, Austria.
2 Clinic for Hand Surgery, Rhoen-Klinikum AG, Bad Neustadt/Saale, Germany.
出版信息
J Hand Surg Eur Vol. 2017 Mar;42(3):253-259. doi: 10.1177/1753193416676723. Epub 2016 Nov 12.
UNLABELLED
We carried out a retrospective study to analyse the long-term outcome of 36 patients after radial shortening osteotomy for treatment of Lichtman Stage IIIA Kienböck disease at a mean follow-up of 12.1 years (range 5.4-17.5). At review, seven wrists had progressed to Stage IIIB, eight wrists to Stage IV and 21 remained in Stage IIIA. Motion and grip strength were significantly improved. The mean Disabilities of the Arm, Shoulder, and Hand (DASH) score at review was 12 points (range 0-52), and patient satisfaction was high. Apart from plate removals in 14 patients and one wrist denervation, no subsequent surgical procedures were done. Radial shortening yields good long-term clinical results, but does not prevent radiographic progression of disease in some patients.
LEVEL OF EVIDENCE
Therapeutic IV.
未标注
我们进行了一项回顾性研究，以分析36例因治疗Lichtman IIIA期Kienböck病而接受桡骨缩短截骨术患者的长期预后，平均随访12.1年（范围5.4 - 17.5年）。复查时，7例腕关节进展至IIIB期，8例腕关节进展至IV期，21例仍处于IIIA期。活动度和握力显著改善。复查时手臂、肩部和手部功能障碍（DASH）评分的平均值为12分（范围0 - 52），患者满意度较高。除14例患者取出钢板和1例腕关节去神经外，未进行后续手术。桡骨缩短术可产生良好的长期临床效果，但不能防止部分患者疾病的影像学进展。
证据水平
治疗性IV级。
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