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[腕关节骨关节炎]

[Osteoarthritis of the wrist].

作者信息

Deglmann C J

机构信息

MünchenHand - Privatpraxis für Hand- und Handgelenkchirurgie, Marienplatz 21, 80333, München, Deutschland.

Deutsches Zentrum für Obere Extremität, Effnerstr. 38, 81925, München, Deutschland.

出版信息

Orthopadie (Heidelb). 2024 Jun;53(6):463-476. doi: 10.1007/s00132-024-04502-w. Epub 2024 May 24.

DOI:10.1007/s00132-024-04502-w
PMID:38789591
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11143053/
Abstract

The term osteoarthritis (OA) of the wrist can be used as an umbrella term for various, often independent areas of OA, as the wrist is made up of several joints. Radiocarpal OA often occurs after untreated ligament injuries, incorrectly healed bone fractures in the carpus or after radius fractures involving the joint. A typical sequence of propagation is known for radiocarpal OA following scapholunate (SL) insufficiency or scaphoid pseudarthrosis. Other causes include inflammation, crystal deposits or bone necrosis. Ulnocarpal arthrosis occurs posttraumatically or primarily when there are differences in levels between the ulna and radius. When treating wrist arthrosis, after conservative measures have been exhausted a surgical procedure should be chosen that enables the best possible load-bearing and residual mobility, considering the surgical risks and individual requirements. During salvage operations, the defective cartilage areas are either fused directly or eliminated using appropriate diverting partial fusions and resection arthroplasty. An accurate analysis of the affected zones is crucial for selecting an appropriate intervention.

摘要

腕关节骨关节炎(OA)这一术语可作为各种通常相互独立的OA区域的统称,因为腕关节由多个关节组成。桡腕关节OA常发生在韧带损伤未治疗、腕骨骨折愈合不良或累及关节的桡骨骨折之后。舟月骨(SL)不稳或舟状骨假关节后桡腕关节OA有典型的传播序列。其他原因包括炎症、晶体沉积或骨坏死。尺腕关节病创伤后发生,或主要在尺骨和桡骨长度不同时出现。治疗腕关节病时,在保守治疗措施用尽后,应选择一种手术方法,在考虑手术风险和个体需求的情况下,尽可能实现最佳的负重和保留残余活动度。在挽救手术中,有缺陷的软骨区域要么直接融合,要么通过适当的转向部分融合和切除关节成形术消除。准确分析受影响区域对于选择合适的干预措施至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b8c2/11143053/c7bd17af292b/132_2024_4502_Fig11_HTML.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b8c2/11143053/347da51d1f9c/132_2024_4502_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b8c2/11143053/06828f295371/132_2024_4502_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b8c2/11143053/e934e44c5eae/132_2024_4502_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b8c2/11143053/c1df3e3566c3/132_2024_4502_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b8c2/11143053/08ff418527b5/132_2024_4502_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b8c2/11143053/4a0ff58ab0be/132_2024_4502_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b8c2/11143053/f1b39f9ca948/132_2024_4502_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b8c2/11143053/c1c375600225/132_2024_4502_Fig8_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b8c2/11143053/87284a1f2e16/132_2024_4502_Fig9_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b8c2/11143053/b56fdb9a3b53/132_2024_4502_Fig10_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b8c2/11143053/c7bd17af292b/132_2024_4502_Fig11_HTML.jpg

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本文引用的文献

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Long-term survivorship of the Herbert ulnar head prosthesis: a multicentre retrospective cohort study.Herbert 尺骨小头假体的长期存活率:一项多中心回顾性队列研究。
J Hand Surg Eur Vol. 2024 Dec;49(11):1350-1355. doi: 10.1177/17531934241238938. Epub 2024 Mar 27.
2
Arthroscopic wafer procedure versus ulnar shortening osteotomy for ulnar impaction syndrome: a systematic review and meta-analysis.关节镜下薄片切除术与尺骨缩短截骨术治疗尺骨撞击综合征的系统评价和荟萃分析。
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Wrist proprioception-An update on scientific insights and clinical implications in rehabilitation of the wrist.
腕关节本体感觉:腕关节康复中科学认识和临床意义的更新。
J Hand Ther. 2024 Apr-Jun;37(2):257-268. doi: 10.1016/j.jht.2023.09.010. Epub 2023 Oct 20.
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Rheumatoid Hand Surgery in the Era of Biologic Therapy: A Rheumatologist-oriented Overview.生物治疗时代的类风湿手部手术:以风湿病学家为导向的概述
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Interdisciplinary consensus statements on imaging of DRUJ instability and TFCC injuries.DRUJ 不稳定和 TFCC 损伤的影像学跨学科共识声明。
Eur Radiol. 2023 Sep;33(9):6322-6338. doi: 10.1007/s00330-023-09698-7. Epub 2023 May 16.
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Total Wrist Arthrodesis: An Update on Indications, Technique and Outcomes.全腕关节融合术:适应证、技术及疗效的最新进展
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Proximal row carpectomy versus four-corner arthrodesis in the treatment of SLAC and SNAC wrist: meta-analysis and literature review.近排腕骨切除术与四角融合术治疗 SLAC 和 SNAC 腕关节:荟萃分析和文献回顾。
Hand Surg Rehabil. 2023 Jun;42(3):194-202. doi: 10.1016/j.hansur.2023.03.006. Epub 2023 Apr 7.
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The distal radio ulnar joint: a journey of discovery and invention of the Aptis prosthesis.远端桡尺关节:Aptis 假体的探索和发明之旅。
J Hand Surg Eur Vol. 2023 Jun;48(6):505-513. doi: 10.1177/17531934221142169. Epub 2022 Dec 15.
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Arch Orthop Trauma Surg. 2023 May;143(5):2789-2795. doi: 10.1007/s00402-022-04728-3. Epub 2022 Dec 14.
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