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对于基底关节骨关节炎,除了迷你带袢钛板悬吊成形术和大多角骨切除术外,应用APL至FCR腱固定悬吊成形术:临床和放射学结果

APL to FCR Tenodesis Suspensionplasty in Addition to Mini Tightrope Suspensionplasty and Trapeziectomy for Basal Joint Osteoarthritis: Clinical and Radiological Outcomes.

作者信息

Hsieh Jason, Chang Hsu-Min, Lo I-Ning, Wu Shang-Liang, Wang Jung-Pan, Huang Yi-Chao

机构信息

Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan.

Department of Orthopedics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.

出版信息

Handchir Mikrochir Plast Chir. 2025 Jun;57(3):218-226. doi: 10.1055/a-2571-4375. Epub 2025 May 30.

DOI:10.1055/a-2571-4375
PMID:40446825
Abstract

This study aims to compare the clinical and radiological outcomes of adding FCR-APL tenodesis to suture-button suspensionplasty following trapeziectomy in the treatment of Basal Joint Osteoarthritis (BJOA).This study is based on a prospectively collected cohort, comparing patients treated with trapeziectomy and suture-button suspensionplasty, with (n=14) or without (n=18) additional APL-FCR suspensionplasty, followed until one month postoperatively. Mid-term outcomes were assessed through retrospective analysis of 29 patients who returned for a routine follow-up more than 12 months after surgery. Outcomes included trapezial space ratio (TSR), patient-reported pain (VAS), Disabilities of the Arm, Shoulder, and Hand (DASH), Patient-Rated Wrist Evaluation (PRWE), range of motion (ROM), and return-to-work time.Both groups demonstrated significant improvements in pain and all functional outcomes, with no significant difference between the groups in DASH, PRWE, and VAS scores as well as in ROM limitation or return-to-work time. TSR reduction was observed in both groups, but there was no significant difference in subsidence between the two. Minor complications occurred in both groups.Both surgical techniques improved patient-reported outcomes. However, the addition of APL-FCR suspensionplasty to suture-button suspensionplasty did not significantly reduce the subsidence of the first metacarpal bone or improve functional results.

摘要

本研究旨在比较在大多角骨切除术后,在缝线纽扣悬吊成形术基础上加用FCR-APL腱固定术治疗第一腕掌关节骨关节炎(BJOA)的临床和影像学结果。本研究基于前瞻性收集的队列,比较接受大多角骨切除术和缝线纽扣悬吊成形术治疗的患者,其中一组(n = 14)加用APL-FCR悬吊成形术,另一组(n = 18)未加用,随访至术后1个月。通过对术后12个月以上进行常规随访的29例患者进行回顾性分析来评估中期结果。结果包括大多角骨间隙比(TSR)、患者报告的疼痛(视觉模拟评分法[VAS])、上肢、肩部和手部功能障碍(DASH)、患者腕关节评估(PRWE)、活动范围(ROM)和重返工作时间。两组在疼痛和所有功能结果方面均有显著改善,两组在DASH、PRWE和VAS评分以及ROM受限或重返工作时间方面无显著差异。两组均观察到TSR降低,但两者在沉降方面无显著差异。两组均发生轻微并发症。两种手术技术均改善了患者报告的结果。然而,在缝线纽扣悬吊成形术基础上加用APL-FCR悬吊成形术并未显著降低第一掌骨的沉降或改善功能结果。

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