Wrist surgery

手腕手术
  • 文章类型: Journal Article
    腕关节镜检查是治疗三角纤维软骨复合体(TFCC)损伤的一种有价值且广泛使用的工具。这些手术包括单纯的滑膜切除术,包膜周围或透骨修复,和关节镜辅助重建,每个都与特定的并发症有关。这篇综述描述了文献和我们中心报道的不同类型的关节镜TFCC手术的并发症类型及其发生率。在关节镜TFCC手术中,并发症发生率和学习曲线随着手术复杂性的增加而增加。相关解剖学,预防和管理并发症,包括神经损伤和刺激,伸肌腱损伤和肌腱炎,骨折,刚度,并讨论了症状或不稳定的持久性。警惕解剖细节和仔细解剖可以帮助减少可能导致令人不安的疼痛和功能丧失的并发症。
    Wrist arthroscopy is a valuable and widely utilized tool in the treatment of triangular fibrocartilage complex (TFCC) injuries. These procedures include synovectomy alone, peri-capsular or transosseous repair, and arthroscopic-assisted reconstruction, and each are associated with specific complications. This review describes the types of complications and their rates in different types of arthroscopic TFCC surgery reported in the literature and in our centre. Across the spectrum of arthroscopic TFCC surgery, complication rates and the learning curve increase with surgical complexity. Relevant anatomy, prevention and management of complications including nerve injury and irritation, extensor tendon injury and tendinitis, fracture, stiffness, and persistence of symptoms or instability are discussed. Vigilance to anatomical details and careful dissection can help to reduce complications that may result in disturbing pain and functional loss.
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    文章类型: Comparative Study
    To compare functional and radiographic outcomes of radius fractures distal to the watershed line treated with variable-angle volar rim locking compression plates (VA-LCP) with traditional fixed-angle volar rim locking compression plates (FA-LCP).
    A retrospective review of patients who underwent open reduction and internal fixation (ORIF) using either VA-LCP (19 wrists) or traditional fixation with FA-LCP (28 wrists). The average follow-up period was 14.5 months (range 11-16 months) for the VA-LCP group and 15.8 months (range 12-18 months) for the FA-LCP group. Clinical outcomes were evaluated using the Modified Mayo wrist score (MMWS), Disabilities of the Arm, Shoulder, and Hand (DASH) score, wrist range of motion (ROM) and grip strength relative to the uninjured side, and signs of flexor tendon irritation. Radiographic evaluation included radial height, radial inclination, volar tilt, and volar tear drop angle. All outcomes were assessed at 3, 6, and 12 months postoperatively.
    MMWS and DASH scores improved with time postoperatively in both groups. Relative ROM was improved in VA-LCP compared to the FA-LCP at 12 months. VA-LCP was associated with a decreased incidence of flexor tendon irritation compared to FA-LCP. VA-LCP also better held the volar tilt reduction compared the FA-LCP.
    VA-LCP shows improved clinical and radiographic outcomes throughout the follow up period when compared to traditional fixation. VA-LCP may be an effective alternative to traditional fixation methods to treat radius fractures distal to the watershed line.
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