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掌骨切除联合或不联合肌腱附加物:基于注册研究的 650 例拇指分析。

Trapeziectomy with or without a tendon-based adjunct: a registry-based study of 650 thumbs.

机构信息

Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden.

Department for Hand Surgery, Södersjukhuset, Stockholm, Sweden.

出版信息

J Hand Surg Eur Vol. 2022 Jul;47(7):728-733. doi: 10.1177/17531934221086220. Epub 2022 Mar 22.

Abstract

This study aimed to assess the outcomes after simple trapeziectomy and trapeziectomy with ligament reconstruction and/or tendon interposition based on data in the Swedish national healthcare quality registry for hand surgery (HAKIR). Six-hundred and fifty thumbs were included, and 265 were assessed up to 12 months after operation. There was significant and clinically relevant improvement in patient-reported measures (pain on load, pain on motion without load, pain at rest, stiffness, weakness, and ability to perform activities of daily living and the Quick Disabilities of the Arm, Shoulder and Hand score) and objective measures (strength and thumb mobility) at 3 and 12 months for all procedures. The use of the abductor pollicis longus tendon had better improvement in some respects compared with the use of flexor carpi radialis or extensor carpi radialis tendons. However, overall, the use of a tendon adjuncts yielded no better outcomes than simple trapeziectomy. III.

摘要

本研究旨在基于瑞典手部外科国家医疗质量登记处(HAKIR)的数据,评估单纯梯形切除术与韧带重建和/或肌腱置入术的治疗结果。共纳入 650 例拇指,其中 265 例在术后 12 个月内进行评估。所有手术在术后 3 个月和 12 个月时,患者报告的测量指标(负重疼痛、无负重运动疼痛、休息时疼痛、僵硬、无力以及日常生活活动能力和 Quick Disabilities of the Arm、Shoulder and Hand 评分)和客观测量指标(握力和拇指活动度)均有显著且具有临床意义的改善。与使用桡侧腕屈肌或桡侧伸腕肌肌腱相比,使用拇长展肌肌腱在某些方面具有更好的改善效果。然而,总的来说,肌腱附加物的使用并未比单纯梯形切除术产生更好的结果。III.

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