手术治疗月骨周围损伤的功能预后
Functional Outcome of Surgically Managed Perilunate Injuries.
作者信息
George Joseph, Kumar Kannan Karuppiah, Vijayakumar Girish, Ravishankar Muniramaiah
机构信息
Hosmat hospital, Bangalore, India.
出版信息
Indian J Orthop. 2020 Aug 11;54(Suppl 2):270-276. doi: 10.1007/s43465-020-00225-0. eCollection 2020 Dec.
BACKGROUND
Perilunate injuries are rare and quite often missed. We present our experience and outcomes, surgically managing these difficult injuries.
METHODS
We analysed data from 14 patients who underwent open reduction and internal fixation of perilunate injuries. All patients underwent open reduction and fixation through the dorsal approach. Fractures were fixed with either K-wires or Headless compression screws. At regular intervals radiographs, range of motion, grip strength, modified Mayo score, Quick DASH score and Lyon wrist scores were collected.
RESULTS
The average age of our patients was 29.2. Average time to surgical intervention was 11.3 days. The mean follow-up period was 42.3 months. modified Mayo wrist score, QuickDASH score and Lyon wrist scores were 77.86, 1.62 and 80.86, respectively. Wrist flexion/extension arc was 101.43. Wrist radial/ulnar deviation was 50.0. Mean grip strength was 69.93% of the opposite side. Radiological evidence of wrist arthritis and lunate avascular necrosis was seen in 8 (57.14%) and 4 (28.6%) cases, respectively.
CONCLUSION
Early open reduction of perilunate injuries gives reliable results, in spite of radiological evidence of wrist arthritis in a majority of the cases.
背景
月骨周围损伤较为罕见，且常常被漏诊。我们介绍我们在手术治疗这些复杂损伤方面的经验及结果。
方法
我们分析了14例行月骨周围损伤切开复位内固定术患者的数据。所有患者均通过背侧入路进行切开复位及固定。骨折采用克氏针或无头加压螺钉固定。定期收集X线片、活动范围、握力、改良梅奥评分、快速DASH评分及里昂腕关节评分。
结果
我们患者的平均年龄为29.2岁。手术干预的平均时间为11.3天。平均随访期为42.3个月。改良梅奥腕关节评分、快速DASH评分及里昂腕关节评分分别为77.86、1.62及80.86。腕关节屈伸弧为101.43。腕关节桡偏/尺偏为50.0。平均握力为对侧的69.93%。分别有8例（57.14%）和4例（28.6%）出现腕关节关节炎及月骨缺血性坏死的影像学证据。
结论
尽管大多数病例有腕关节关节炎的影像学证据，但月骨周围损伤的早期切开复位仍能取得可靠的结果。
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