Dolan Joshua D, Shiver Luke, Wallace Doyle, Whitehead Jonathon, Wood Matthew, Fulcher S Mark
Department of Orthopaedic Surgery, Medical College of Georgia, Augusta, Georgia, United States.
J Hand Microsurg. 2024 May 14;16(2):100041. doi: 10.1055/s-0043-1769748. eCollection 2024 Jun.
Various pathologies of the adult carpus result in clinical scenarios where excision can be considered and even recommended. In the appropriate patient population, isolated carpal excision can alleviate pain and improve mobility. Excisions of the pisiform, trapezium, and trapezoid have abundant literature evidence to support positive long-term functional outcomes. In contrast, isolated excision of the capitate, hamate, and triquetrum has limited support in the literature secondary to compromise of carpal mechanics and lead to recurrent pain. Additionally, isolated scaphoid and lunate excision are best avoided secondary to carpal collapse and should be paired with concomitant stabilizing procedures in the carpus. This article provides a comprehensive literature review of isolated excision of each osseous carpal bone, their indications, and previously assessed outcomes.
成人腕骨的各种病变会导致一些临床情况,在这些情况下可以考虑甚至推荐进行切除术。在合适的患者群体中,孤立性腕骨切除可以缓解疼痛并改善活动能力。豌豆骨、大多角骨和小多角骨的切除有大量文献证据支持长期功能预后良好。相比之下,头状骨、钩骨和三角骨的孤立性切除在文献中的支持有限,因为这会损害腕骨力学并导致复发性疼痛。此外,由于腕骨塌陷,最好避免孤立性舟骨和月骨切除,并且应同时进行腕骨稳定手术。本文对每块腕骨的孤立性切除、其适应症以及先前评估的结果进行了全面的文献综述。