Chen Raymond E, Calfee Ryan P, Stepan Jeffrey G, Osei Daniel A
Department of Orthopedic Surgery, University of Rochester, Rochester, NY.
Department of Orthopedic Surgery, Washington University School of Medicine, St. Louis, MO.
J Hand Surg Glob Online. 2021 Dec 17;4(2):103-110. doi: 10.1016/j.jhsg.2021.10.007. eCollection 2022 Mar.
This study investigated the long-term outcomes of direct scapholunate ligament (SLL) repairs with or without dorsal capsulodesis performed within 6 weeks (acute repair) of a SLL tear versus 6 to 12 weeks following injury (subacute repair).
A review of medical records from April 1996 to April 2012 identified 24 patients who underwent SLL repair (12 acute, 12 subacute). Patients returned to the clinic for radiographic examinations of the injured wrist, standardized physical examinations, and validated questionnaires.
The mean follow-up times for the acute and subacute groups were 7.2 and 6.2 years, respectively. At the final examination, patients with acute surgery regained more wrist extension (acute = 55°, subacute = 47°). The total wrist flexion-extension arcs, grip strengths, pinch strengths, and patient-rated outcome scores were found to be similar between groups. The final scapholunate gap, scapholunate angle, and the prevalence of arthritis were also found to be similar between the acute and subacute groups.
Although SLL repair is more commonly recommended for treatment of acute SLL injuries, there were no significant long-term differences between acute and subacute SLL surgeries (repair ± capsulodesis).
TYPE OF STUDY/LEVEL OF EVIDENCE: Prognostic III.
本研究调查了舟月韧带（SLL）损伤6周内（急性修复）与损伤6至12周后（亚急性修复）进行直接舟月韧带修复（伴或不伴背侧关节囊固定术）的长期疗效。
回顾1996年4月至2012年4月的病历，确定24例接受舟月韧带修复的患者（12例急性损伤，12例亚急性损伤）。患者返回诊所接受受伤手腕的影像学检查、标准化体格检查和经过验证的问卷调查。
急性组和亚急性组的平均随访时间分别为7.2年和6.2年。在最后一次检查时，接受急性手术的患者恢复了更多的腕关节伸展（急性组=55°，亚急性组=47°）。发现两组之间的总腕关节屈伸弧度、握力、捏力和患者评分结果相似。急性组和亚急性组之间的最终舟月间隙、舟月角和关节炎患病率也相似。
虽然舟月韧带修复更常用于治疗急性舟月韧带损伤，但急性和亚急性舟月韧带手术（修复±关节囊固定术）之间没有显著的长期差异。
研究类型/证据水平：预后性III级。
