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腕背腱鞘囊肿的手术治疗:一项回顾性临床试验

Surgical Treatment of Dorsal Carpal Ganglions: A Retrospective Clinical Trial.

作者信息

Alp Nazmi Bülent, Akdag Gokhan

机构信息

Orthopaedics and Traumatology, Bursa City Training and Research Hospital, Bursa, TUR.

Orthopaedics and Traumatology, Istanbul Bahcelievler State Hospital, Istanbul, TUR.

出版信息

Cureus. 2020 Sep 5;12(9):e10252. doi: 10.7759/cureus.10252.

Abstract

Objectives Our primary goal in this study was to investigate whether the surgical treatment we performed on the patients with dorsal carpal ganglion was effective rather than evaluating preoperative and postoperative functional results. Methods The retrospective study included patients who were operated with open technique due to dorsal wrist ganglion at a single center between March 1, 2015, and December 1, 2017, and were followed for at least six months. Thirty-three wrists of 32 patients (31 unilateral and 1 bilateral) were operated. During follow-ups, complication rates, patient satisfaction, and recurrence rates were evaluated. Results Of the 32 patients, 19 were females and 13 were males. Mean age of the patients was 38.6 ± 13.0 years (min-max = 19-60 years). Excision was performed on 28 right and 5 left wrists. The follow-up period of patients varied between 6 months and 38 months (mean = 21.7 ± 9.4 months). Recurrence was detected in four (12.5%) patients during the postoperative period. Complex regional pain syndrome occurred in two (6.25%) patients. Joint stiffness developed in six (18.75%) patients during the postoperative period. When recurrent cases were excluded from our cases, the satisfaction rate was 87.5%. Conclusions Open surgical excision has satisfactory results that cannot be achieved with conservative treatment in the treatment of symptomatic dorsal ganglia. In order to keep the recurrence rate at the minimum level after surgery, it is critical to excise the ganglion and pedicle without leaving any residual tissue. Proper surgical technique improves patient satisfaction by eliminating pain and cosmetic discomfort.

摘要

目的 本研究的主要目标是调查我们对腕背腱鞘囊肿患者实施的手术治疗是否有效,而非评估术前和术后的功能结果。方法 这项回顾性研究纳入了2015年3月1日至2017年12月1日期间在单一中心因腕背腱鞘囊肿接受开放手术治疗且随访至少6个月的患者。对32例患者(31例单侧,1例双侧)的33个腕关节进行了手术。在随访期间,评估并发症发生率、患者满意度和复发率。结果 32例患者中,女性19例,男性13例。患者的平均年龄为38.6±13.0岁(最小-最大=19-60岁)。对28个右手腕和5个左手腕进行了切除。患者的随访期在6个月至38个月之间(平均=21.7±9.4个月)。术后有4例(12.5%)患者出现复发。2例(6.25%)患者发生复杂性区域疼痛综合征。6例(18.75%)患者在术后出现关节僵硬。排除复发病例后,满意度为87.5%。结论 对于有症状的腕背腱鞘囊肿,开放手术切除具有保守治疗无法达到的满意效果。为了将术后复发率降至最低水平,关键是完整切除囊肿和蒂部,不留任何残余组织。正确的手术技术通过消除疼痛和美容不适来提高患者满意度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a366/7478616/733e62c67c26/cureus-0012-00000010252-i01.jpg

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