Haugstvedt Jan Ragnar, Rigó István Zoltán
Division of Hand Surgery, Department of Orthopedics, Østfold Hospital Trust, Moss, Norway.
J Wrist Surg. 2021 Feb;10(1):2-8. doi: 10.1055/s-0040-1716354. Epub 2020 Sep 14.
Injuries of the lunotrirquetral ligament (LT lig) could be part of an extensive carpal injury and are then often treated at the time of the injury. However, when an injury of the LT ligament occurs alone, the injury is often missed. Treatment of this injury has traditionally been by open surgery, such as reattachment of the LT ligament, ligament reconstruction, or arthrodesis of the LT joint. These procedures needed a large exposure to the carpus running the risk of damaging the external ligaments, the nerves important for proprioception, and the capsule with the potential of scarring and adhesions. We describe a novel arthroscopic assisted technique for reconstruction of the LT ligament. Using this less invasive technique, there is a possible advantage of lesser scarring and faster mobilization. We have performed this technique in two patients with more than 30 months follow-up. They both have great improvement of the functional scores. The novel arthroscopic assisted technique for LT lig reconstruction is a technically demanding procedure; however, this obtains good clinical results with more than 30 months follow-up due to less exposure of the carpus. This is a Level IV, case series study.
月三角韧带（LT韧带）损伤可能是广泛腕骨损伤的一部分，通常在损伤时进行治疗。然而，当LT韧带单独损伤时，这种损伤常常被漏诊。传统上，这种损伤的治疗方法是开放手术，如LT韧带重新附着、韧带重建或LT关节融合术。这些手术需要广泛暴露腕骨，有损伤外部韧带、对本体感觉重要的神经以及关节囊的风险，还可能形成瘢痕和粘连。 我们描述了一种新型关节镜辅助技术用于LT韧带重建。使用这种侵入性较小的技术，可能具有瘢痕形成较少和恢复活动更快的优势。 我们已对两名患者实施了该技术，并进行了超过30个月的随访。他们的功能评分均有显著改善。 LT韧带重建的新型关节镜辅助技术是一项技术要求较高的手术；然而，由于腕骨暴露较少，在超过30个月的随访中获得了良好的临床效果。 这是一项IV级病例系列研究。
