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微创间接牵张治疗陈旧性下尺桡关节脱位——一种新型手术技术

Mini-invasive Indirect Distraction in the Treatment of Neglected DRUJ Dislocations-A Novel Surgical Technique.

作者信息

Czinner Martin, Verstreken Frederik, Kebrle Radek

机构信息

Department of Orthopaedic, Liberec Regional Hospital, Liberec, Czech Republic.

Department of Hand Surgery, Dr. Pirek's Clinic, Mladá Boleslav, Czech Republic.

出版信息

J Wrist Surg. 2023 Oct 13;13(6):578-583. doi: 10.1055/s-0043-1772712. eCollection 2024 Dec.

Abstract

This study presents mini-invasive indirect distraction in the treatment of neglected distal radioulnar joint (DRUJ) dislocations as a novel surgical technique. Pure DRUJ dislocation is a rare injury caused by over rotation of the forearm. It is often undiagnosed in an acute setting. There is no consensus on the treatment of neglected dislocations.  We present a group of six patients with neglected pure DRUJ dislocation, treated by a single surgeon between 2012 and 2019.  Closed reduction was impossible in six of six patients. The indirect distraction allowed the reduction of the DRUJ in all cases with final stable DRUJ. Forearm rotation returned to normal in four patients, one patient had 50%, and another patient had 60% of the range of forearm. Mean pain dropped from 7 to 0.8 on visual analog scale. At the 2-year follow-up, the mean Disabilities of the Arm, Shoulder, and Hand score was 8 (0-37.5), and minor degenerative X-ray changes were observed in four patients.  IV.

摘要

本研究提出了一种微创间接牵张技术,用于治疗被忽视的下尺桡关节(DRUJ)脱位,这是一种新型的外科技术。单纯的DRUJ脱位是一种由前臂过度旋转引起的罕见损伤。在急性情况下,它常常未被诊断出来。对于被忽视的脱位的治疗尚无共识。我们报告一组6例被忽视的单纯DRUJ脱位患者,于2012年至2019年间由同一位外科医生进行治疗。6例患者均无法进行闭合复位。间接牵张使所有病例的DRUJ均得以复位,最终DRUJ稳定。4例患者的前臂旋转恢复正常,1例患者恢复了50%,另1例患者恢复了60%的前臂旋转范围。视觉模拟量表上的平均疼痛评分从七分降至0.8分。在2年随访时,手臂、肩部和手部功能障碍的平均评分为8分(0 - 37.5分),4例患者观察到轻微的X线退行性改变。四、

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