Abstract：
The treatment of carpal boss is primarily conservative. Surgical treatment by performing a wedge excision of the bony protrusion, is possible. However, a common belief exists that carpal boss should not be operated because of the high recurrence rate. Additionally, little is known about the clinical outcomes of wedge excision and the preferred post-operative treatment. Patients with carpal boss and persisting pain who underwent wedge excision after conservative treatment were included. They received questionnaires before and three months after surgery. The primary outcomes were pain and hand function measured using patient-reported wrist evaluations (PRWE). Secondarily, recurrence, patient satisfaction and time until return to work were evaluated. These clinical outcomes were also compared between patients who received a plaster splint or a pressure dressing post-operatively. 76 patients were included. Three months after surgery, a significant improvement in PRWE was seen, for both pain and function. A re-operation rate for recurrent carpal boss of 13% was observed. After three months, 58% of patients were satisfied and 73% had returned to work. While no differences in clinical outcomes were found, patients were more satisfied after receiving a pressure dressing than a plaster splint post-operatively. The current study demonstrates encouraging early outcomes after wedge excision, and a low recurrence re-operation rate. Furthermore, a pressure dressing seems preferable post-operatively compared to a plaster splint.
摘要：
腕骨的治疗主要是保守的。通过楔形切除骨突进行手术治疗，是可能的。然而,人们普遍认为，由于高复发率，不应对腕骨进行手术。此外,对楔形切除术的临床结局和首选的术后治疗知之甚少.包括保守治疗后接受楔形切除术的腕骨和持续疼痛的患者。他们在手术前和手术后三个月接受了调查问卷。主要结果是使用患者报告的腕部评估（PRWE）测量的疼痛和手功能。其次，复发,对患者满意度和恢复工作时间进行了评估.这些临床结果也在术后接受石膏夹板或压力敷料的患者之间进行了比较。包括76例患者。手术三个月后,看到了PRWE的显着改善，疼痛和功能。观察到复发性腕骨的再手术率为13％。三个月后,58％的患者感到满意，73％的患者重返工作岗位。虽然没有发现临床结果的差异，术后接受压力敷料的患者比接受石膏夹板的患者更满意。目前的研究表明，楔形切除术后的早期结果令人鼓舞，和低复发再手术率。此外，与石膏夹板相比，术后压力敷料似乎更可取。
