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50岁以上患者的近端腕骨切除术:3至16年的随访

Proximal row carpectomy in patients older than 50 years: 3 to 16 years of follow-up.

作者信息

Montiel V, Payo-Ollero J, Amillo S

机构信息

Departamento Cirugía Ortopédica y Traumatología, Clínica Universidad de Navarra, Pamplona, Navarra, España.

Departamento Cirugía Ortopédica y Traumatología, Clínica Universidad de Navarra, Pamplona, Navarra, España.

出版信息

Rev Esp Cir Ortop Traumatol (Engl Ed). 2019 Jul-Aug;63(4):295-299. doi: 10.1016/j.recot.2019.02.001. Epub 2019 Mar 27.

Abstract

OBJECTIVE

To analyze the long-term results and the prognosis of patients who have undergone proximal row carpectomy (PRC) in our hospital.

MATERIAL AND METHOD

This is a retrospective study of 14 patients undergoing PRC with a follow-up of 3 to 16 years. The ability to perform daily activities, mobility and functional capacity after the surgery were assessed using the Patient-Rated Wrist Evaluation questionnaire (PRWE).

RESULTS

The range of movement was satisfactory. The mean score on the PRWE scale was 20.9±17.2 for the pain subscale and 39±35.5 for the functional capacity subscale. None of the patients required revision surgery or developed complications. Eighty percent of the patients were satisfied or very satisfied. Ninety percent of the patients would undergo surgery again.

DISCUSSION

The wrist's range of movement achieved with this technique is similar to that obtained with other mobility preservation techniques. Secondary arthritic changes in the radio-capitate joint do not necessarily produce pain. Some authors have described that the degree of satisfaction after PRC is equivalent to that of other procedures such as arthrodesis in 4 corners with circular plate arthrodesis or middle-carpal arthrodesis.

CONCLUSION

PRC achieved high satisfaction rates among the patients providing pain relief, good mobility and post-operative functionality of the wrist. In addition, it presented few complications.

摘要

目的

分析在我院接受近排腕骨切除术(PRC)患者的长期结果及预后。

材料与方法

这是一项对14例行PRC患者的回顾性研究,随访时间为3至16年。采用患者自评腕关节评估问卷(PRWE)评估术后日常活动能力、活动度及功能状态。

结果

活动范围令人满意。PRWE量表疼痛子量表的平均评分为20.9±17.2,功能能力子量表的平均评分为39±35.5。无一例患者需要翻修手术或出现并发症。80%的患者满意或非常满意。90%的患者愿意再次接受手术。

讨论

该技术所获得的腕关节活动范围与其他保留活动度技术所获得的相似。桡头关节的继发性关节炎改变不一定会引起疼痛。一些作者描述,PRC术后的满意度与其他手术如四角融合术加环形钢板融合术或中腕关节融合术相当。

结论

PRC在患者中获得了较高的满意度,能缓解疼痛,提供良好的腕关节活动度及术后功能。此外,并发症较少。

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