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本文引用的文献

1
Ulnar-Sided Wrist Pain: A Diagnostic Evaluation Guide From 30-Plus Years of Experience.尺侧腕部疼痛:基于30多年经验的诊断评估指南
Cureus. 2024 Jan 31;16(1):e53332. doi: 10.7759/cureus.53332. eCollection 2024 Jan.
2
Predictors of Secondary Ulnar Shortening and Reoperation After Arthroscopic TFCC Debridement.关节镜下 TFCC 清创术后尺骨缩短和再次手术的预测因素。
Hand (N Y). 2022 Nov;17(6):1147-1153. doi: 10.1177/1558944720977534. Epub 2021 Feb 3.
3
Correlation of the Lateral Wrist Radiograph to Ulnar Variance: A Cadaveric Study.腕部外侧X线片与尺骨变异的相关性:一项尸体研究。
J Hand Surg Am. 2018 Oct;43(10):951.e1-951.e9. doi: 10.1016/j.jhsa.2018.02.021. Epub 2018 Mar 27.
4
A Systematic Review of Outcomes after Arthroscopic Débridement for Triangular Fibrocartilage Complex Tear.关节镜下清创治疗三角纤维软骨复合体撕裂术后结局的系统评价
Plast Reconstr Surg. 2017 Nov;140(5):697e-708e. doi: 10.1097/PRS.0000000000003750.
5
Preventable Repeat Wrist Arthroscopies: Analysis of the Indications for 133 Cases.可预防的重复性腕关节镜检查:133例病例的指征分析。
J Wrist Surg. 2017 Feb;6(1):33-38. doi: 10.1055/s-0036-1584311. Epub 2016 Jun 1.
6
Functionality after arthroscopic debridement of central triangular fibrocartilage tears with central perforations.关节镜下对伴有中央穿孔的中央三角纤维软骨撕裂进行清创后的功能
J Hand Surg Am. 2015 Feb;40(2):252-258.e2. doi: 10.1016/j.jhsa.2014.10.056.
7
Measurement of ulnar variance from the lateral radiograph: a comparison of techniques.从外侧位X线片测量尺骨变异:技术比较
J Hand Surg Am. 2014 Jun;39(6):1114-21. doi: 10.1016/j.jhsa.2014.03.024. Epub 2014 May 5.
8
Revision wrist arthroscopy after failed primary arthroscopic treatment.初次关节镜治疗失败后的腕关节镜翻修术。
J Wrist Surg. 2014 Feb;3(1):30-6. doi: 10.1055/s-0033-1364090.
9
Simple debridement has little useful value on the clinical course of recalcitrant ulnar wrist pain.单纯清创对顽固性尺侧腕痛的临床病程几乎没有什么有用价值。
Bone Joint J. 2013 Dec;95-B(12):1687-96. doi: 10.1302/0301-620X.95B12.31918.
10
Different evolutionary pathways underlie the morphology of wrist bones in hominoids.不同的进化途径为同源人科腕骨的形态学提供了基础。
BMC Evol Biol. 2013 Oct 23;13:229. doi: 10.1186/1471-2148-13-229.

掌握三角纤维软骨复合体撕裂:一项关于三角纤维软骨复合体清创术结果的回顾性比较研究

Getting a Grip on Triangular Fibrocartilage Complex Tears: A Retrospective Comparative Study on Triangular Fibrocartilage Complex Debridement Outcomes.

作者信息

Mirza Ather, Mirza Justin B, Zappia Luke C, Thomas Terence L, Song Junho

机构信息

North Shore Surgi-Center, Smithtown, New York.

Mirza Orthopedics, Smithtown, New York.

出版信息

J Wrist Surg. 2024 Jul 5;14(5):406-411. doi: 10.1055/s-0044-1787751. eCollection 2025 Oct.

DOI:10.1055/s-0044-1787751
PMID:40995553
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12456991/
Abstract

BACKGROUND

A retrospective analysis was performed to compare the clinical outcomes and complications of patients who underwent triangular fibrocartilage complex (TFCC) debridement based on gripping posteroanterior (PA) view ulnar variance measures.

MATERIALS AND METHODS

Patients in Group A (  = 17) demonstrated ulnar variance measures <1.0 mm on the standard PA view and ≥1.0 mm on the gripping PA view. Patients in Group B (  = 13) maintained ulnar variance measures <1.0 mm on standard and gripping PA views. Clinical outcome measures included return to work, visual analog scale (VAS) scores, and range of motion. Complications included persistent pain, postoperative injections, and indication for revision surgery. Qualitative and quantitative measures were analyzed using Fisher exact tests and Student's -tests, respectively.

RESULTS

Significantly more patients in Group A (7/17) did not return to work compared with Group B (1/13) (  < 0.05). Mean VAS scores decreased from 7.0 to 5.3 in Group A and from 6.8 to 2.0 in Group B. Group A reported lower flexion-extension and pronation-supination arcs compared with Group B (110 vs. 130 degrees and 161 vs. 174 degrees) (  < 0.05). Significantly more patients in Group A (10/17) reported persistent pain at ≥3 months postoperatively compared with Group B (2/13)  < 0.05). Seven cases were indicated for revision surgery in Group A, while no cases were indicated in Group B (  < 0.05).

CONCLUSION

Patients in Group A reported inferior clinical outcomes compared with Group B based on pain, range of motion, and indication for revision surgery. Dynamic ulnar variance may play a role in the clinical outcomes of patients treated with TFCC debridement.

LEVEL OF EVIDENCE

Level IV.

TYPE OF STUDY/LEVEL OF EVIDENCE: Retrospective Comparative Study/Level IV.

摘要

背景

进行一项回顾性分析,以比较根据握持后前位(PA)位尺骨变异测量结果接受三角纤维软骨复合体(TFCC)清创术的患者的临床结局和并发症。

材料与方法

A组(n = 17)患者在标准PA位上尺骨变异测量值<1.0 mm,在握持PA位上≥1.0 mm。B组(n = 13)患者在标准PA位和握持PA位上尺骨变异测量值均<1.0 mm。临床结局指标包括重返工作、视觉模拟量表(VAS)评分和活动范围。并发症包括持续疼痛、术后注射以及翻修手术指征。分别使用Fisher精确检验和学生t检验对定性和定量指标进行分析。

结果

与B组(1/13)相比,A组(7/17)中未重返工作的患者明显更多(P<0.05)。A组的平均VAS评分从7.0降至5.3,B组从6.8降至2.0。与B组相比,A组报告的屈伸和旋前 - 旋后弧度更低(分别为110°对130°和161°对174°)(P<0.05)。与B组(2/13)相比,A组(10/17)中术后≥3个月报告持续疼痛的患者明显更多(P<0.05)。A组有7例患者需要进行翻修手术,而B组无病例需要(P<0.05)。

结论

基于疼痛、活动范围和翻修手术指征,A组患者的临床结局比B组差。动态尺骨变异可能在接受TFCC清创术患者的临床结局中起作用。

证据级别

IV级。

研究类型/证据级别:回顾性比较研究/IV级。