自体掌长肌腱微创解剖韧带重建术治疗下尺桡关节陈旧性脱位

发布时间：2018-03-25 06:18

本文选题：下尺桡关节脱位　切入点：陈旧性　出处：《中国矫形外科杂志》2017年18期

【摘要】：[目的]探讨自体掌长肌腱微创解剖韧带重建术治疗下尺桡关节陈旧性脱位的疗效。[方法]回顾性分析2015年1月~2016年12月应用自体掌长肌腱微创解剖韧带重建术治疗5例下尺桡关节陈旧性脱位的患者,术中对下尺桡关节间隙进行清理、保护性修复三角韧带复合体(TFCC)后,采用自体肌腱韧带重建技术弹性固定下尺桡关节。术后1周及3个月复查X线片及CT,术后6个月采用改良Mayo腕关节功能评分标准评定疗效。[结果]下尺桡关节脱位均获复位,症状明显减轻,前臂旋转功能良好。无感染、切口愈合不良及静脉血栓等并发症。5例患者术后获6~15个月(平均10个月)随访。术后1周和3个月复查X线片及CT提示下尺桡关节复位良好。术后6个月改良Mayo腕关节功能评分结果:由术前的平均57分上升至90分。优4例,良1例,优良率100%。[结论]自体掌长肌腱微创解剖韧带重建术治疗下尺桡关节陈旧性脱位可以保留下尺桡关节生理性微动、无需二次手术取出及避免了下尺桡关节再脱位,患者术后腕关节功能恢复良好,无明显并发症发生,短期疗效满意。
[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.
【作者单位】：常州市第一人民医院骨科;金坛中医院骨科;
【分类号】：R687.4

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