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关节镜下背侧韧带囊紧缩术治疗孤立性舟月骨间韧带损伤:22 例回顾性病例系列研究。

Arthroscopic Dorsal Ligamentocapsulodesis in the Treatment of Isolated Lunotriquetral Interosseous Ligamentous Injury: A Retrospective Case Series of 22 Patients.

机构信息

Department of Orthopedics and Traumatology, Gaziosmanpaşa Hospital, Yeni Yüzyıl University, Gaziosmanpaşa, Istanbul, Turkey.

Department of Orthopedics and Traumatology, Atatürk University, Istanbul, Turkey.

出版信息

J Hand Surg Asian Pac Vol. 2022 Jun;27(3):480-490. doi: 10.1142/S2424835522500485. Epub 2022 May 27.

Abstract

The literature is scarce regarding isolated tears of lunotriquetral interosseous ligament (LTIL). The purpose of this study was to present mid-term clinical and functional results of arthroscopic dorsal ligamentocapsulodesis in the treatment of isolated LTIL tears. Twenty-two patients (8 females, 14 males; mean age: 31 years; age range: 18-42) with isolated LTIL tears verified by wrist arthroscopy were retrospectively reviewed and included in the study. The mean follow-up was 55 months (range: 24-84). The modified Mayo wrist score, visual analog scale (VAS), flexion and extension deficits of passive wrist range of motion (ROM), pain-free ROM with forced wrist extension and grip strength were measured in all patients preoperatively and at final follow-up. The mean modified Mayo wrist score significantly improved from 50 ± 10.29 preoperatively (range: 30-65) to 86 ± 11.61 (range: 60-100) at the final follow-up ( < 0.001). The mean VAS score significantly improved from 7.1 ± 0.83 (range: 6-8) preoperatively to 2.2 ± 1.35 (range: 0-6; < 0.001) at the final follow-up. At the final follow-up examination, the forced wrist extension was painless in all but three patients who developed pain at 70º, 75º and 80º of extension, respectively. The mean strength of hand grip significantly increased from 38.6 ± 9.68 (range: 24-54) kg to 49.5 ± 12.36 (range: 33-66) kg at the final assessment ( < 0.001). No major complications were observed during or after the procedure. With the encouraging mid-term outcomes and a lower complication rate, arthroscopic LTIL dorsal ligamentocapsulodesis seems to be a safe and effective surgical technique in improving functional outcomes and reducing pain in patients with isolated LTIL tears. Level IV (Therapeutic).

摘要

孤立性月三角骨间掌侧韧带(LTIL)撕裂的文献报道较少。本研究旨在介绍关节镜下背侧韧带囊紧缩术治疗孤立性 LTIL 撕裂的中期临床和功能结果。

回顾性分析 22 例(8 例女性,14 例男性;平均年龄 31 岁;年龄范围 18-42 岁)经腕关节镜证实为孤立性 LTIL 撕裂的患者,并纳入本研究。平均随访时间为 55 个月(范围 24-84 个月)。所有患者术前和末次随访时均测量改良 Mayo 腕关节评分、视觉模拟评分(VAS)、腕关节屈伸活动度(ROM)的被动屈伸度差值、无疼痛的强迫腕伸 ROM 和握力。

改良 Mayo 腕关节评分从术前的 50±10.29(范围 30-65)显著提高至末次随访时的 86±11.61(范围 60-100)( < 0.001)。VAS 评分从术前的 7.1±0.83(范围 6-8)显著改善至末次随访时的 2.2±1.35(范围 0-6; < 0.001)。末次随访时,除 3 例患者分别在 70°、75°和 80°伸展时出现疼痛外,其余患者的强迫腕伸均无痛。握力从术前的 38.6±9.68(范围 24-54)kg 显著提高至末次评估时的 49.5±12.36(范围 33-66)kg( < 0.001)。术中及术后无重大并发症发生。

关节镜下 LTIL 背侧韧带囊紧缩术具有中期疗效满意和并发症发生率低的优点,似乎是一种安全有效的手术技术,可改善孤立性 LTIL 撕裂患者的功能结果并减轻疼痛。

四级(治疗性)。

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