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关节镜下双骨隧道修复三角纤维软骨复合体 Palmer ⅠB 型损伤。

Arthroscopic dual-bone tunnel repair for palmer type IB injuries of the triangular fibrocartilage complex.

机构信息

Department of Orthopedics, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, No. 68, Gehu Middle Road, Wujin District, Changzhou, 213000, Jiangsu, China.

出版信息

BMC Musculoskelet Disord. 2024 Aug 27;25(1):671. doi: 10.1186/s12891-024-07809-z.

Abstract

BACKGROUND

Triangular fibrocartilage complex (TFCC) injuries, especially Palmer type IB, pose surgical management challenges due to associated distal radial ulnar joint (DRUJ) instability. Traditional surgeries entail risks of complications. Arthroscopic repair presents advantages but lacks consensus on optimal techniques. To evaluate arthroscopic dual-bone tunnel repair in patients with Palmer type IB TFCC injuries of the wrist.

METHODS

In this retrospective case series, grip strength ratio, joint range of motion, pain visual analogue scale (VAS), modified Mayo wrist score, and Disabilities of the Arm, Shoulder, and Hand (DASH) scores were assessed before and 12 months after surgery.

RESULTS

The cohort consisted of 45 patients. At 12 months, the grip strength ratio improved from 0.71 ± 0.08 to 0.93 ± 0.05 (P < 0.001), and wrist joint rotation increased from 126.78 ± 13.28° to 145.76 ± 8.52° (P < 0.001). VAS (1.60 ± 0.58 vs. 6.33 ± 0.91, P < 0.001), DASH (12.96 ± 3.18 vs. 46.87 ± 6.62, P < 0.001), and modified Mayo wrist (88.11 ± 4.43 vs. 63.78 ± 7.99, P < 0.001) scores all improved after surgery. The overall complication rate was 4.44%.

CONCLUSION

Arthroscopic dual-bone tunnel repair appears to be an effective intervention for alleviating wrist pain, restoring stability, and enhancing joint function in patients with TFCC Palmer type IB injuries.

摘要

背景

三角纤维软骨复合体(TFCC)损伤,特别是 Palmer 型 IB 型,由于与桡腕关节(DRUJ)不稳定相关,给手术治疗带来了挑战。传统手术存在并发症风险。关节镜修复具有优势,但在最佳技术方面尚未达成共识。评估腕关节 TFCC Palmer 型 IB 损伤患者的关节镜双骨隧道修复术。

方法

在这项回顾性病例系列研究中,在手术前后评估握力比、关节活动范围、疼痛视觉模拟量表(VAS)评分、改良 Mayo 腕关节评分和上肢残疾问卷(DASH)评分。

结果

该队列包括 45 例患者。12 个月时,握力比从 0.71±0.08 提高到 0.93±0.05(P<0.001),腕关节旋转从 126.78±13.28°提高到 145.76±8.52°(P<0.001)。VAS(1.60±0.58 比 6.33±0.91,P<0.001)、DASH(12.96±3.18 比 46.87±6.62,P<0.001)和改良 Mayo 腕关节评分(88.11±4.43 比 63.78±7.99,P<0.001)均在手术后改善。总的并发症发生率为 4.44%。

结论

关节镜双骨隧道修复术似乎是一种有效的干预措施,可以缓解腕关节疼痛,恢复稳定性,提高 TFCC Palmer 型 IB 损伤患者的关节功能。

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