O'Shaughnessy Maureen A, Wagner Eric R, Berger Richard A, Kakar Sanjeev
Mayo Clinic, Rochester, MN, USA.
Hand (N Y). 2019 Sep;14(5):602-608. doi: 10.1177/1558944718760031. Epub 2018 Mar 5.
This study reviews long-term outcomes of partial wrist denervation focusing on need for and time to revision procedure. A retrospective study was conducted of all patients undergoing partial wrist denervation between 1994 and 2014. At average latest follow-up of 6.75 years (range, 1-21 years), clinical and radiographic data and need for revision surgery were recorded. There were 100 wrists in 89 patients (61 male, 28 female) with average age at surgery of 54 years (range, 26-80). Principal diagnoses were arthritis (58%), inflammatory (19%), and posttraumatic arthritis (7%). Average flexion-extension arc was 83% and grip strength 75% of unaffected extremity. Average Mayo Wrist Scores improved from 48 preoperatively to 77 postoperatively. Sixty-nine percent of patients did not undergo other procedures during the time interval studied. Thirty-one percent underwent revision at an average of 26 months following denervation (range, 2-165). Partial wrist denervation is a motion-preserving procedure for patients with refractory wrist pain with 69% in this series requiring no further procedures. The remaining 31% experienced average symptom relief for 2 years prior to ultimately undergoing revision operation.
本研究回顾了部分腕部去神经支配术的长期疗效，重点关注翻修手术的必要性和时间。对1994年至2014年间接受部分腕部去神经支配术的所有患者进行了一项回顾性研究。在平均6.75年（范围1 - 21年）的最新随访中，记录了临床和影像学数据以及翻修手术的必要性。89例患者共100只腕部（男性61例，女性28例），手术时平均年龄54岁（范围26 - 80岁）。主要诊断为关节炎（58%）、炎症性疾病（19%）和创伤后关节炎（7%）。平均屈伸弧度为健侧肢体的83%，握力为健侧肢体的75%。平均梅奥腕关节评分从术前的48分提高到术后的77分。69%的患者在研究时间段内未接受其他手术。31%的患者在去神经支配术后平均26个月（范围2 - 165个月）接受了翻修手术。部分腕部去神经支配术是一种保留运动功能的手术，适用于难治性腕部疼痛患者，本系列中69%的患者无需进一步手术。其余31%的患者在最终接受翻修手术前平均有2年的症状缓解期。
