舟状骨周围损伤行急性近排腕骨切除术的病例报告。
A Case for Acute Proximal Row Carpectomy for Perilunate Injuries.
机构信息
Department of Orthopaedics and Rehabilitation, The University of New Mexico Hospital, Albuquerque, New Mexico, USA.
出版信息
Iowa Orthop J. 2023 Dec;43(2):14-19.
BACKGROUND
Perilunate injuries are complex injuries typically arising from high-energy injuries to the wrist. Standard treatment involves open reduction and internal fixation with ligamentous reconstruction; however, outcomes are fraught with complications including pain, stiffness, and arthrosis. Several case reports have demonstrated the role of proximal row carpectomy as a salvage procedure for complex carpal trauma in the setting of significant cartilage injury or bone loss. The authors believe that proximal row carpectomy may be an appropriate acute treatment in certain patient populations, with functional results similar to those obtained with ligamentous reconstruction.
METHODS
A retrospective review of two cases with perilunate dislocations managed with primary proximal row carpectomy are presented.
RESULTS
At greater than 1-year follow-up, both patients had stable radiocarpal alignment. Quick-DASH scores were 22.7 and 27.3.
CONCLUSION
Primary proximal row carpectomy is a treatment option in the acute setting for perilunate injuries in elderly, lower-demand patients. Functional results are similar to those obtained with ligamentous reconstruction, with a shorter recovery period. .
背景
舟月损伤是一种复杂的损伤，通常由腕部高能损伤引起。标准治疗方法包括切开复位内固定和韧带重建；然而，其结果常伴有并发症，包括疼痛、僵硬和关节炎。一些病例报告已经证明了近排腕骨切除术作为一种复杂腕部创伤的挽救性手术，适用于存在明显软骨损伤或骨丢失的情况。作者认为，近排腕骨切除术可能是某些特定患者群体的一种合适的急性治疗方法，其功能结果与韧带重建相似。
方法
回顾性分析了两例采用初次近排腕骨切除术治疗的舟月骨脱位病例。
结果
随访时间超过 1 年，两名患者的腕骨放射学排列均稳定。Quick-DASH 评分为 22.7 和 27.3。
结论
对于老年、低需求患者的急性舟月骨损伤，初次近排腕骨切除术是一种治疗选择。功能结果与韧带重建相似，但恢复时间更短。
Zotero 插件