Department of Plastic, Reconstructive and Hand Surgery, Erasmus Medical Centre, Rotterdam, The Netherlands.
Department of Plastic, Reconstructive and Hand Surgery, Amsterdam UMC, Amsterdam, The Netherlands.
J Hand Surg Am. 2024 Jul;49(7):712.e1-712.e9. doi: 10.1016/j.jhsa.2022.09.012. Epub 2022 Nov 28.
Multiple studies report outcomes after 3-ligament tenodesis (3-LT) in treating traumatic scapholunate interosseous ligament injury (SLIL). However, investigators do not differentiate between patients with partial or complete SLIL injury. The relation between the extent of SLIL disruption and surgical outcomes and if this should be considered when treating a patient with SLIL injury remains unknown. We aimed to evaluate differences in patient-rated wrist evaluation (PRWE) scores, satisfaction and return to work between patients with partial or complete chronic traumatic SLIL injury treated with 3 ligament tenodesis at 12 months after surgery.
All patients with chronic SLIL injury (partial and complete) who were treated with 3-LT at our clinic and received the same postoperative management between December 2011 and December 2019 were studied. Only patients who had completed the PRWE and return to work questionnaires preoperatively and 12 months after surgery were included. Patients were allocated to the partial (classified as Geissler 2 or 3) or complete SLIL injury group (classified as Geissler 4) by retrospectively assessing wrist arthroscopy reports.
Thirty-nine patients with partial and 90 with complete SLIL injuries were included. At 1-year follow-up, PRWE scores had significantly improved in both groups. When adjusting for clinical baseline characteristics, there was no statistically significant difference between patients with partial or complete SLIL injury. Patients with complete SLIL injury had a 70% higher return to work within the first 12 months after 3-LT; however, satisfaction with the treatment result was similar for both study groups 1 year after surgery.
Patients with complete and partial traumatic SLIL injury report better PRWE total scores at 12 months after 3-LT, but there was no statistically significant difference between the groups in PRWE scores or satisfaction with the treatment result.
TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.
多项研究报告了治疗创伤性舟月骨间韧带损伤(SLIL)的三韧带固定术(3-LT)后的结果。然而,研究人员并未对部分或完全性 SLIL 损伤患者进行区分。SLIL 撕裂程度与手术结果之间的关系,以及在治疗 SLIL 损伤患者时是否应考虑这一点,目前仍不清楚。我们旨在评估在接受 3 韧带固定术治疗的慢性创伤性 SLIL 损伤患者中,部分或完全性慢性创伤性 SLIL 损伤患者在术后 12 个月时,患者腕关节评估(PRWE)评分、满意度和重返工作之间的差异。
研究对象为 2011 年 12 月至 2019 年 12 月在我们诊所接受 3-LT 治疗且接受相同术后管理的所有慢性 SLIL 损伤(部分和完全)患者。仅纳入术前和术后 12 个月完成 PRWE 和重返工作调查问卷的患者。通过回顾性评估腕关节镜报告,将患者分为部分(分类为 Geissler 2 或 3)或完全 SLIL 损伤组(分类为 Geissler 4)。
共有 39 名部分性和 90 名完全性 SLIL 损伤患者纳入研究。在 1 年随访时,两组的 PRWE 评分均显著改善。当调整临床基线特征后,部分性和完全性 SLIL 损伤患者之间无统计学显著差异。完全性 SLIL 损伤患者在 3-LT 后 12 个月内重返工作的比例高 70%;然而,两组患者在术后 1 年对治疗结果的满意度相似。
在接受 3-LT 治疗 12 个月后,完全性和部分性创伤性 SLIL 损伤患者的 PRWE 总分报告更好,但两组之间的 PRWE 评分或对治疗结果的满意度无统计学显著差异。
研究类型/证据水平:治疗性 IV 级。