From the Section of Plastic Surgery, The University of Michigan Health System.
Department of Plastic, Reconstructive, and Aesthetic Surgery, Nippon Medical School.
Plast Reconstr Surg. 2023 Jan 1;151(1):143-147. doi: 10.1097/PRS.0000000000009786. Epub 2022 Oct 11.
Intercarpal ligament injuries such as scapholunate and lunotriquetral tears are common causes of wrist pain. There is no shortage of surgical techniques to address these injuries, nor is there a lack of literature exploring this topic. However, research progress has not led to a consensus regarding the optimal management of subacute and chronic injuries without articular wear. The senior author (K.C.C.) has performed the spectrum of reconstructive techniques, including dorsal and volar approaches, tendon weaves, ligament tenodesis procedures, reduction and association procedures, and bone-ligament-bone techniques. In the absence of convincing, consistent outcomes, the authors began investigating a novel all-dorsal reconstructive technique using the Arthrex InternalBrace system. The complexity and unpredictable outcomes associated with traditional ligament tenodesis procedures led them to adopt the all-dorsal InternalBrace technique as their primary reconstructive approach. The authors have performed more than 20 procedures with this technique since 2019. In an average tourniquet time of under 60 minutes, they are able to achieve predictable carpal stabilization, pain relief, and restoration of motion. This is the preferred reconstructive approach of the senior author.
腕骨间韧带损伤,如舟月和月三角韧带撕裂,是腕痛的常见原因。针对这些损伤的手术技术并不缺乏,也不乏探索这一主题的文献。然而,研究进展并没有导致人们对无关节磨损的亚急性和慢性损伤的最佳治疗方法达成共识。资深作者(K.C.C.)已经实施了一系列的重建技术,包括背侧和掌侧入路、肌腱编织、韧带肌腱固定术、复位和联合术以及骨-韧带-骨技术。由于缺乏令人信服和一致的结果,作者开始研究一种新的全背侧重建技术,使用 Arthrex InternalBrace 系统。传统的韧带肌腱固定术相关的复杂性和不可预测的结果促使他们采用全背侧 InternalBrace 技术作为主要的重建方法。自 2019 年以来,作者已经使用该技术完成了 20 多例手术。在平均 60 分钟以下的止血带时间内,他们能够实现可预测的腕骨稳定性、疼痛缓解和运动恢复。这是资深作者首选的重建方法。