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关节镜下部分腕掌切开缝合扣悬吊成形术治疗拇指腕掌关节炎的临床疗效。

Clinical Results of Arthroscopic Partial Trapeziectomy With Suture-Button Suspensionplasty for Thumb Carpometacarpal Arthritis.

机构信息

Rehabilitation Unit, Kyoto University Hospital, Japan.

Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Japan.

出版信息

Hand (N Y). 2023 Jul;18(5):740-745. doi: 10.1177/15589447221075663. Epub 2022 Feb 12.

Abstract

BACKGROUND

This study represents the clinical results, especially range of motion (ROM) improvement, of arthroscopic partial trapeziectomy with suture-button suspensionplasty for symptomatic grade II and III thumb carpometacarpal arthritis with a minimum 1-year follow-up.

METHODS

Thirty-two patients (mean: 67.5 years) with grade II and III thumb carpometacarpal arthritis treated with arthroscopic partial trapeziectomy with suture-button suspensionplasty were retrospectively followed up for at least 1 year. The physical assessments included ROM, pain visual analogue scale (VAS), strength, and the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire. The physical variables were retrospectively compared before surgery and at the final follow-up.

RESULTS

Preoperative radial abduction and palmar abduction (45.4 ± 16.4° and 54.3 ± 13.9°, respectively) were significantly increased at the final follow-up (59.7 ± 16.9° and 65.5 ± 14.2°, respectively). Preoperative VAS score, pinch strength, and DASH score (70.5 ± 14.0, 57.2 ± 24.8% and 36.8 ± 14.8, respectively) were also significantly improved at the final follow-up (7.9 ± 9.1, 91.0 ± 39.6%, and 11.7 ± 10.5, respectively). Complications involved 1 case of irritation of the superficial branch of the radial nerve and 1 case of dystonia. Two suture-buttons were removed due to patient discomfort.

CONCLUSIONS

A significant increase in ROM and pain relief was obtained after suture-button suspensionplasty with arthroscopic partial trapeziectomy.

摘要

背景

本研究代表了关节镜下部分梯形切除术联合缝线纽扣悬吊术治疗 II 级和 III 级拇指腕掌关节炎的临床结果,特别是在至少 1 年的随访中,关节活动度(ROM)的改善。

方法

回顾性随访了 32 例(平均年龄:67.5 岁)接受关节镜下部分梯形切除术联合缝线纽扣悬吊术治疗的 II 级和 III 级拇指腕掌关节炎患者,随访时间至少 1 年。体格评估包括 ROM、疼痛视觉模拟评分(VAS)、力量和上肢残疾问卷(DASH)。将体格变量与术前和最终随访时进行比较。

结果

术前桡偏和掌偏(分别为 45.4±16.4°和 54.3±13.9°)在最终随访时显著增加(分别为 59.7±16.9°和 65.5±14.2°)。术前 VAS 评分、捏力和 DASH 评分(分别为 70.5±14.0、57.2±24.8%和 36.8±14.8)在最终随访时也显著改善(分别为 7.9±9.1、91.0±39.6%和 11.7±10.5)。并发症包括 1 例桡神经浅支激惹和 1 例运动障碍。由于患者不适,有 2 个缝线纽扣被取出。

结论

关节镜下部分梯形切除术联合缝线纽扣悬吊术可显著增加 ROM 并缓解疼痛。

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Evidence-Based Medicine: Thumb Basal Joint Arthritis.循证医学:拇指腕掌关节关节炎
Plast Reconstr Surg. 2017 Jan;139(1):256e-266e. doi: 10.1097/PRS.0000000000002858.

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