Kirschenbaum D, Coyle M P, Leddy J P
Robert Wood Johnson Medical School, Division of Orthopaedic Surgery, New Brunswick, NJ.
J Hand Surg Am. 1993 Nov;18(6):1107-12. doi: 10.1016/0363-5023(93)90411-U.
Fourteen patients with chronic lunotriquetral instability were evaluated. Forced wrist extension was the most common mechanism of injury. Fourteen patients underwent lunotriquetral arthrodesis. Arthrograms were positive in 9 of the 12 performed. In three cases abnormalities not identified by arthrography were demonstrated by arthroscopy. The follow-up period averaged 27 months. X-ray films showed fusion in 12 cases. One pseudarthrosis was asymptomatic. A second pseudarthrosis required a rearthrodesis that became solid 8 weeks after surgery. One patient had persistent wrist pain. Wrist motion compared to the contralateral side averaged 85%, 88%, 83% and 80%, respectively, for flexion, extension, ulnar deviation, and radial deviation. Grip strength compared to the contralateral side averaged 93%. Lunotriquetral instability is a clinical diagnosis confirmed by arthrography or arthroscopy. Lunotriquetral fusion reliably relieves pain while maintaining functional wrist motion and grip strength. The long-term effects of lunotriquetral fusion on carpal kinematics and wrist function are unknown.
对14例慢性月三角骨不稳患者进行了评估。腕关节强迫背伸是最常见的损伤机制。14例患者接受了月三角骨融合术。12例进行了关节造影，其中9例结果为阳性。3例关节造影未发现的异常通过关节镜检查得以证实。随访期平均为27个月。X线片显示12例融合。1例假关节无症状。另1例假关节需要再次进行融合术，术后8周融合牢固。1例患者腕部持续疼痛。与对侧相比，腕关节的屈曲、背伸、尺偏和桡偏活动度分别平均为85%、88%、83%和80%。握力与对侧相比平均为93%。月三角骨不稳是一种通过关节造影或关节镜检查确诊的临床诊断。月三角骨融合术能可靠地缓解疼痛，同时保持腕关节的功能活动度和握力。月三角骨融合术对腕骨运动学和腕关节功能的长期影响尚不清楚。
