背景:三角纤维软骨复合体(TFCC)损伤,尤其是帕尔默IB型,由于相关的桡骨远端尺关节(DRUJ)不稳定,对手术管理提出了挑战。传统手术会带来并发症的风险。关节镜修复具有优势,但对最佳技术缺乏共识。探讨关节镜下双骨隧道修复术在腕关节PalmerIB型TFCC损伤患者中的应用价值。
方法:在本回顾性病例系列中,握力比,关节运动范围,疼痛视觉模拟评分(VAS),改良梅奥手腕评分,和手臂的残疾,肩膀,术前和术后12个月进行DASH评分和Hand评分。
结果:队列包括45名患者。12个月时,握力比从0.71±0.08提高到0.93±0.05(P<0.001),腕关节旋转从126.78±13.28°增加到145.76±8.52°(P<0.001)。VAS(1.60±0.58vs.6.33±0.91,P<0.001),DASH(12.96±3.18vs.46.87±6.62,P<0.001),和改良的梅奥手腕(88.11±4.43vs.63.78±7.99,P<0.001)评分术后均有改善。总并发症发生率为4.44%。
结论:关节镜下双骨隧道修复似乎是缓解腕关节疼痛的有效干预措施。恢复稳定性,增强TFCCPalmerIB型损伤患者的关节功能。
BACKGROUND: Triangular fibrocartilage complex (TFCC) injuries, especially Palmer type IB, pose surgical management challenges due to associated distal radial ulnar joint (DRUJ) instability. Traditional surgeries entail risks of complications. Arthroscopic repair presents advantages but lacks consensus on optimal techniques. To evaluate arthroscopic dual-bone tunnel repair in patients with Palmer type IB TFCC injuries of the wrist.
METHODS: In this retrospective case series, grip strength ratio, joint range of motion, pain visual analogue scale (VAS), modified Mayo wrist score, and Disabilities of the Arm, Shoulder, and Hand (DASH) scores were assessed before and 12 months after surgery.
RESULTS: The cohort consisted of 45 patients. At 12 months, the grip strength ratio improved from 0.71 ± 0.08 to 0.93 ± 0.05 (P < 0.001), and wrist joint rotation increased from 126.78 ± 13.28° to 145.76 ± 8.52° (P < 0.001). VAS (1.60 ± 0.58 vs. 6.33 ± 0.91, P < 0.001), DASH (12.96 ± 3.18 vs. 46.87 ± 6.62, P < 0.001), and modified Mayo wrist (88.11 ± 4.43 vs. 63.78 ± 7.99, P < 0.001) scores all improved after surgery. The overall complication rate was 4.44%.
CONCLUSIONS: Arthroscopic dual-bone tunnel repair appears to be an effective intervention for alleviating wrist pain, restoring stability, and enhancing joint function in patients with TFCC Palmer type IB injuries.