Aita Marcio Aurelio, Oliveira Ricardo Kaempf de, Biondi Bruno Gianordoli, Gómez Gustavo Luis Rodriguez, Tamura Marcos Jun, Ruggiero Gustavo Mantovani
Departamento de Cirurgia, Ortopedia e Trauma, Divisão de Mão e Microcirurgia, Faculdade de Medicina do ABC, São Bernardo do Campo, SP, Brasil.
Departamento de Ortopedia e Trauma, Santa Casa de Porto Alegre, Porto Alegre, RS, Brasil.
Rev Bras Ortop (Sao Paulo). 2024 Dec 27;59(Suppl 2):e168-e172. doi: 10.1055/s-0044-1790593. eCollection 2024 Nov.
To measure the life quality, clinical-functional outcomes of a patient who had undergone acute reconstruction of radio scapho capitate (RSC), radio lunate (RLL) ligaments, using brachiorradialis tendon in treatment of radiocarpal fracture dislocation. 21-years-old, man with radiocarpal fracture dislocation in his left wrist, after motorcycle accident. Percutaneous screw fixation of the distal radius and acute reconstruction of the RSC and RLL was performed, assisted by arthroscopy. One year later, the patient experienced good evaluation. ROM was full, grip strength was 96% compared with the unaffected side were obtained. Wrist radiographic aspects showed fracture healed and radiocarpal joint congruency. Good stability and joint congruency of the radiocarpal joint were obtained and improving the life quality of that patient. Radiocarpal fracture dislocation management is difficult and complicated. There is no consensus. As there is still a lack of long-term results, the indications for surgery, and options, type of the intervention have been a matter of controversy in the literature. Would radiocarpal (RC) joint be stable when reconstruction of the radiocarpal ligaments, using brachiorradialis tendon was obtained? Is it possible to reduce and to maintain stable radiocarpal joint with this technique? The clinical relevance of this work is our suggestion of reconstruction of the RC ligament to improve this treatment. We believe that this will maintain a stable and functional wrist. We agree that the best time to perform corrections is as soon as possible and we prefer to reconstruct the RC ligament with suture or temporary or permanent radioscapholunate arthrodesis.
为评估一名因摩托车事故导致左腕桡腕骨折脱位，接受桡舟头（RSC）、桡月（RLL）韧带急性重建术（采用肱桡肌腱治疗）患者的生活质量及临床功能结局。患者为21岁男性。在关节镜辅助下，对桡骨远端进行经皮螺钉固定，并对RSC和RLL进行急性重建。一年后，患者评估良好。活动范围正常，握力与未受伤侧相比达到96%。腕部X线片显示骨折愈合，桡腕关节匹配。桡腕关节获得了良好的稳定性和关节匹配性，患者生活质量得到改善。桡腕骨折脱位的处理困难且复杂。目前尚无共识。由于仍缺乏长期结果，手术指征、选择及干预类型在文献中一直存在争议。采用肱桡肌腱重建桡腕韧带时，桡腕（RC）关节会稳定吗？用这种技术能否复位并维持桡腕关节稳定？这项工作的临床意义在于我们建议重建RC韧带以改进治疗。我们认为这将维持腕关节的稳定和功能。我们同意尽早进行矫正，并且更倾向于用缝线或临时或永久性桡舟月关节融合术重建RC韧带。
