本文選題：下尺橈關(guān)節(jié)脫位　切入點(diǎn)：陳舊性　出處：《中國矯形外科雜志》2017年18期

【摘要】：[目的]探討自體掌長肌腱微創(chuàng)解剖韌帶重建術(shù)治療下尺橈關(guān)節(jié)陳舊性脫位的療效。[方法]回顧性分析2015年1月~2016年12月應(yīng)用自體掌長肌腱微創(chuàng)解剖韌帶重建術(shù)治療5例下尺橈關(guān)節(jié)陳舊性脫位的患者,術(shù)中對(duì)下尺橈關(guān)節(jié)間隙進(jìn)行清理、保護(hù)性修復(fù)三角韌帶復(fù)合體(TFCC)后,采用自體肌腱韌帶重建技術(shù)彈性固定下尺橈關(guān)節(jié)。術(shù)后1周及3個(gè)月復(fù)查X線片及CT,術(shù)后6個(gè)月采用改良Mayo腕關(guān)節(jié)功能評(píng)分標(biāo)準(zhǔn)評(píng)定療效。[結(jié)果]下尺橈關(guān)節(jié)脫位均獲復(fù)位,癥狀明顯減輕,前臂旋轉(zhuǎn)功能良好。無感染、切口愈合不良及靜脈血栓等并發(fā)癥。5例患者術(shù)后獲6~15個(gè)月(平均10個(gè)月)隨訪。術(shù)后1周和3個(gè)月復(fù)查X線片及CT提示下尺橈關(guān)節(jié)復(fù)位良好。術(shù)后6個(gè)月改良Mayo腕關(guān)節(jié)功能評(píng)分結(jié)果:由術(shù)前的平均57分上升至90分。優(yōu)4例,良1例,優(yōu)良率100%。[結(jié)論]自體掌長肌腱微創(chuàng)解剖韌帶重建術(shù)治療下尺橈關(guān)節(jié)陳舊性脫位可以保留下尺橈關(guān)節(jié)生理性微動(dòng)、無需二次手術(shù)取出及避免了下尺橈關(guān)節(jié)再脫位,患者術(shù)后腕關(guān)節(jié)功能恢復(fù)良好,無明顯并發(fā)癥發(fā)生,短期療效滿意。
[Abstract]:[objective] to investigate the effect of minimally invasive anatomic ligament reconstruction of the tendon of the palmar longus tendon in the treatment of the old dislocation of the ulnar and radial joint. [methods] A retrospective analysis was made on the reconstruction of the anatomical ligament of the tendon from January 2015 to December 2016. Treatment of 5 cases of old dislocation of the lower ulnar and radial joint, The space of the lower ulnar and radial joint was cleared during the operation, and the triangular ligament complex was repaired with protection. The ulnar and radial joints were fixed with autogenous tendon ligament reconstruction technique. X-ray films and CTLs were re-examined at 1 week and 3 months after operation. The curative effect was evaluated by modified Mayo wrist function scoring standard 6 months after operation. [results] the dislocation of the lower ulnar and radial joint was reduced. The symptoms were obviously alleviated, and the forearm rotation function was good. Follow-up of 6 ~ 15 months (mean 10 months) was obtained in 5 patients with complications such as poor wound healing and venous thrombosis. X-ray and CT findings at 1 and 3 months after operation indicated that the reduction of the ulnar and radial joint was satisfactory. The modified Mayo was improved 6 months after operation. Wrist function score: from the preoperative average of 57 to 90, excellent 4 cases, One case was good, the excellent and good rate was 100%. [conclusion] minimally invasive anatomical ligaments reconstruction of autogenous palmar longus tendon for the treatment of the old dislocation of the ulnar radial joint can preserve the physiological fretting of the lower ulnar and radial joint, without the need of secondary operation, and avoid the redislocation of the lower ulnar radial joint. The wrist function recovered well after operation, no obvious complications occurred, and the short-term curative effect was satisfactory.
【作者單位】： 常州市第一人民醫(yī)院骨科;金壇中醫(yī)院骨科;
【分類號(hào)】：R687.4

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