CAJ | 학술논문

目的总结应用腕关节镜技术诊断并治疗40例单纯三角纤维软骨复合体(TFCC)损伤的经验.方法 40例患者中男24例,女16例;平均年龄37.3岁.应用常规腕关节镜入路和器械对桡腕关节和腕中关节进行检查,对TFCC损伤的诊断采用Palmer分型,腕关节镜视下诊断为TFCC Ⅰ型损伤30例、Ⅱ型损伤10例.明确诊断后对TFCCⅠ A、ⅠD型行清创术;ⅠB、ⅠC型行镜下修复术;TFCCⅡ型损伤行清创术;对有尺骨撞击的TFCCⅡC和ⅡD型损伤行关节镜下尺骨头部分磨除术(Wafer术)治疗.术前和术后随访评定采用改良Mayo腕关节功能评分.结果镜下TFCC清创及修复术均顺利;术后有1例患者出现环指主动背伸不能(后经手术探查为环指指伸肌腱断裂),余患者均无并发症;平均随访时间为11.6个月.经改良Mayo腕关节功能评分:优21例,良13例,可5例,差1例;优良率为85.0％,患者自我满意率为97.5％.结论应用腕关节镜技术诊断并治疗TFCC损伤安全有效,随访效果确切可靠,值得推广应用.
목적 총결응용완관절경기술진단병치료40례단순삼각섬유연골복합체(TFCC)손상적경험.방법 40례환자중남24례,녀16례;평균년령37.3세.응용상규완관절경입로화기계대뇨완관절화완중관절진행검사,대TFCC손상적진단채용Palmer분형,완관절경시하진단위TFCC Ⅰ형손상30례、Ⅱ형손상10례.명학진단후대TFCCⅠ A、ⅠD형행청창술;ⅠB、ⅠC형행경하수복술;TFCCⅡ형손상행청창술;대유척골당격적TFCCⅡC화ⅡD형손상행관절경하척골두부분마제술(Wafer술)치료.술전화술후수방평정채용개량Mayo완관절공능평분.결과 경하TFCC청창급수복술균순리;술후유1례환자출현배지주동배신불능(후경수술탐사위배지지신기건단렬),여환자균무병발증;평균수방시간위11.6개월.경개량Mayo완관절공능평분:우21례,량13례,가5례,차1례;우량솔위85.0％,환자자아만의솔위97.5％.결론 응용완관절경기술진단병치료TFCC손상안전유효,수방효과학절가고,치득추엄응용.
Objective To summarize the experience of wrist arthroscpic diagnosis and treatment of simple TFCC lesions in 40 cases.Methods There were 24 males and 16 females in this 40 case series.The average patient age was 37.3 years.Routine wrist arthroscopy portals and instrumentation were used to exam the radiocarpal and midcarpal joints.The pathologic TFCC lesions were diagnosed according to Palmer' s Classification Scales.TFCC IA and ID lesions were treated with debridement under the arthroscopy,while IB and IC lesions were repaired.IIC and IID lesions with ulnar head impingement underwent Wafer procedure under the arthoscopy.Pre- and post-operative wrist functions were evaluated using the modified Mayo wrist score.Results Arthroscopic diagnosis confirmed TFCC type Ⅰ lesions in 30 cases and type Ⅱ lesions in 10 cases.All the arthroscopic procedures of debridement and repair were successful except for one case with ring finger extensor tendon rupture,which was later confirmed and treated by open surgery.No other complications were noted.The average follow-up period was 11.6 months.According to the modified Mayo wrist score the results were rated as excellent in 21 cases,good in 13 cases,fair in 5 cases and poor in 1 case.The overall satisfactory rate was 85.0％.Patients' satisfaction rate was 97.5％.Conclusion Wrist arthroscopic diagnosis and treatment of TFCC lesions is safe and effective.The clinical outcome is reliable.It is a technique worth recommending.