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关节镜下三角纤维软骨复合体修复术后的患者报告结局

Patient-Reported Outcomes following Arthroscopic Triangular Fibrocartilage Complex Repair.

作者信息

Selles Caroline A, d'Ailly Philip N, Schep Niels W L

机构信息

Department of Trauma and Hand Surgery, Maasstad Hospital, Rotterdam, the Netherlands.

Trauma Unit, Department of Surgery, Amsterdam UMC location AMC, Amsterdam, the Netherlands.

出版信息

J Wrist Surg. 2020 Feb;9(1):58-62. doi: 10.1055/s-0039-3400454. Epub 2019 Nov 26.

Abstract

Triangular fibrocartilage complex (TFCC) injury is a common cause of ulnar-sided wrist pain, which may lead to serious physical impairments. Arthroscopic repair has benefits such as less soft tissue damage, greater surgical accuracy, and may lead to faster recovery than open repair.  The purpose of this study was to determine the functional outcome of patients with symptomatic TFCC injuries treated with arthroscopic debridement or repair.  A retrospective study of all consecutive patients with a TFCC injury treated arthroscopically was conducted. The primary outcome was the patient-rated wrist evaluation (PRWE) score. Secondary outcomes were, pain, operative findings, complications, and additional treatment.  A total of 51 patients with a median follow-up of 16.5 months (interquartile range [IQR]: 13-25) were included. Injuries were treated with TFCC debridement (  = 25), TFCC ligament to capsule suturing (  = 10), TFCC debridement and ligament to capsule suturing (  = 7), TFCC debridement and synovectomy (  = 5), and TFCC foveal reinsertion with a suture anchor (  = 4). The median PRWE was 19.5 (IQR: 6-49). Complications occurred in three patients and in nine patients additional surgery was performed.  Arthroscopic treatment of TFCC lesions leads to satisfactory functional outcomes.  This is a Level IV study.

摘要

三角纤维软骨复合体(TFCC)损伤是尺侧腕部疼痛的常见原因,可能导致严重的身体功能障碍。关节镜修复具有软组织损伤小、手术精度高的优点,并且可能比开放修复恢复得更快。本研究的目的是确定经关节镜清创或修复治疗的有症状TFCC损伤患者的功能结局。对所有经关节镜治疗的连续性TFCC损伤患者进行了一项回顾性研究。主要结局是患者自评腕关节评估(PRWE)评分。次要结局包括疼痛、手术发现、并发症和额外治疗。共纳入51例患者,中位随访时间为16.5个月(四分位间距[IQR]:13 - 25)。损伤的治疗方式包括TFCC清创(n = 25)、TFCC韧带至关节囊缝合(n = 10)、TFCC清创及韧带至关节囊缝合(n = 7)、TFCC清创及滑膜切除术(n = 5)以及用缝合锚钉进行TFCC中央凹重新固定(n = 4)。PRWE评分中位数为19.5(IQR:6 - 49)。3例患者出现并发症,9例患者接受了额外手术。关节镜治疗TFCC损伤可带来满意的功能结局。这是一项IV级研究。

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