Department of Orthopaedic Surgery, University of Kansas School of Medicine, Wichita, KS, USA.
Advanced Orthopaedic Associates, Wichita, KS, USA.
J Hand Surg Eur Vol. 2020 Nov;45(9):909-915. doi: 10.1177/1753193420942668. Epub 2020 Jul 24.
This retrospective study investigated the clinical outcomes of patients treated for chronic distal radioulnar joint instability with open anatomic reconstruction of the palmar and dorsal radioulnar ligaments. After the midpoint of a tendon graft is anchored at the ulnar fovea, the two graft limbs traverse the distal radioulnar joint. One limb is woven into the palmar wrist capsule and the other is secured to the dorsal wrist capsule and retinaculum to stabilize the joint. Of 30 patients (31 wrists) treated with this technique, 19 were followed longitudinally for a mean of 10 years (range 3-21). In this long-term cohort, there were statistically significant improvements in ulnar-sided wrist pain on the visual analogue scale and in distal radioulnar joint stability on the dorsopalmar stress test. The modified Mayo Wrist Scores were classified as three excellent, 12 good, three fair and one poor. Of the 30 patients studied, failure occurred in four patients, two from graft rupture and two from distal radioulnar joint arthrosis. We conclude that anatomic reconstruction of the palmar and dorsal radioulnar ligaments is an effective treatment for distal radioulnar joint instability and is associated with high satisfaction and durable outcomes. IV.
这项回顾性研究调查了接受慢性远侧桡尺关节不稳定开放性解剖重建掌侧和背侧桡尺侧韧带的患者的临床结果。在肌腱移植物的中点锚固在尺骨窝后，两个移植物分支穿过远侧桡尺关节。一个分支编织到手掌腕关节囊，另一个固定在手背腕关节囊和支持带以稳定关节。在接受该技术治疗的 30 名患者（31 只手腕）中，有 19 名患者进行了平均 10 年（3-21 年）的纵向随访。在这个长期队列中，腕关节尺侧疼痛的视觉模拟评分和背侧掌侧压力测试的远侧桡尺关节稳定性均有显著改善。改良 Mayo 腕关节评分分为 3 个优，12 个良，3 个可，1 个差。在研究的 30 名患者中，有 4 名患者失败，其中 2 名患者因移植物断裂，2 名患者因远侧桡尺关节关节炎。我们得出结论，掌侧和背侧桡尺侧韧带的解剖重建是治疗远侧桡尺关节不稳定的有效方法，与高满意度和持久的结果相关。IV。
