Department of Hand Surgery, Plastic and Reconstructive Surgery, Centre Chirurgical Emile Gallé, CHU Nancy, France.
Service de Chirurgie de la Main - SOS main. Hôpital Privé Dijon Bourgogne, France.
J Hand Surg Eur Vol. 2021 Mar;46(3):278-285. doi: 10.1177/1753193420940498. Epub 2020 Jul 19.
We modified our original surgical technique of scapholunate intercarpal ligamentoplasty for treating chronic scapholunate dissociation. The aim of this study was to compare the outcomes in patients treated by the same surgical team with the original method and the modified method over two different time periods. Nineteen patients with a mean age of 40 years were treated with the original method (mean follow-up of 34 months, range 12-54), and 21 patients with a mean age of 38 years were treated with the modified method (mean follow-up of 27 months, range 13-40). In both groups, we found a significant improvement in pain levels, grip strength, functional scores in terms of QuickDASH and Patient-Rated Wrist Evaluation, and radiographic scapholunate gap and scapholunate angle after surgery. There were no significant differences between the two groups in outcome measures except the scapholunate gap, which was significantly better controlled by the modified procedure. Between the immediate postoperative period and the last follow-up, there was a significant increase in the scapholunate gap and scapholunate angle after the original method, while there only a small increase after the modified method. We conclude that both versions of the scapholunate intercarpal ligamentoplasty yield satisfactory clinical and radiological results in the short to mid-term. The modified method makes the triquetral surgical step easier and seems to better optimize the tension across the ligamentoplasty, thus maintaining the intercarpal correction. III.
我们对治疗慢性舟月骨分离的舟月骨间韧带成形术的原始手术技术进行了改进。本研究的目的是比较同一手术团队在两个不同时期采用原始方法和改良方法治疗的患者的结果。19 名平均年龄为 40 岁的患者采用原始方法治疗（平均随访 34 个月，范围 12-54），21 名平均年龄为 38 岁的患者采用改良方法治疗（平均随访 27 个月，范围 13-40）。在两组中，我们发现术后疼痛水平、握力、QuickDASH 和患者腕部评估的功能评分以及舟月骨间隙和舟月骨角均有显著改善。除了改良组的舟月骨间隙明显更好控制外，两组在其他结果测量上没有显著差异。与原始方法相比，改良方法在术后即刻和末次随访时舟月骨间隙和舟月骨角均有显著增加，而原始方法仅略有增加。我们的结论是，两种版本的舟月骨间韧带成形术在短期至中期均能获得满意的临床和影像学结果。改良方法使三角骨的手术步骤更容易，并且似乎可以更好地优化韧带成形术的张力，从而保持腕骨间的矫正。III。
