CAJ | 학술논문

目的采用腕关节镜辅助射频皱缩技术治疗腕骨间韧带部分损伤合并TFCC(triangular fibrocartilage complex,三角纤维软骨复合体)损伤,并初步评估其治疗效果.方法对8例腕关节疼痛的患者,关节镜检查发现腕骨闻韧带部分损伤合并TFCC损伤,予清创后利用射频器对腕骨间韧带和TFCC残缘进行射频皱缩.术后观察其疼痛情况,关节各项活动度,握、捏力,并用改良Mayo腕关节评分及DASH量表评分评估其功能情况.结果术后随访时间平均为10个月(6～12个月).3例疼痛完全消失,4例疼痛明显减轻,1例尚无明显好转.按改良Mayo腕关节评分:术前平均51.3(30～70),术后平均78.1(45～95).按DASH量表评分:术前平均39.3(18.3～49.3),术后平均19.2(8.8～28.7).两种评分术后均较术前有明显改善.术后无关节炎、手背神经损伤等并发症表现.结论关节镜下射频皱缩对腕骨间韧带部分损伤合并TFCC损伤是一种有效的治疗手段.
목적 채용완관절경보조사빈추축기술치료완골간인대부분손상합병TFCC(triangular fibrocartilage complex,삼각섬유연골복합체)손상,병초보평고기치료효과.방법 대8례완관절동통적환자,관절경검사발현완골문인대부분손상합병TFCC손상,여청창후이용사빈기대완골간인대화TFCC잔연진행사빈추축.술후관찰기동통정황,관절각항활동도,악、날력,병용개량Mayo완관절평분급DASH량표평분평고기공능정황.결과 술후수방시간평균위10개월(6～12개월).3례동통완전소실,4례동통명현감경,1례상무명현호전.안개량Mayo완관절평분:술전평균51.3(30～70),술후평균78.1(45～95).안DASH량표평분:술전평균39.3(18.3～49.3),술후평균19.2(8.8～28.7).량충평분술후균교술전유명현개선.술후무관절염、수배신경손상등병발증표현.결론 관절경하사빈추축대완골간인대부분손상합병TFCC손상시일충유효적치료수단.
Objective To evaluate the prdiminary results of arthroscopic thermal capsular shrinkage for partial intercarpal interosseous ligament injuries.combined with.TFCC injuries.Methods Eight patients with wrist pain were included in this study.Diagnostic arthroscopy showed partial intercarpal imerosseous ligamem injuries combined with TFCC injuries in these patients.After debridement using a shaver.a monopoLar radiofrequency probe was used to shrink the interearpal imeroeous ligament and the fringed edges of TFCC.Postoperatively pain,wrist motion,grip and pinch strength were evaluated.Wrist function was assessed using modified Mayo wrist score and DASH questionnaire. Results Follow up interview and examination were conducted 10 months(range 6-12 months)postoperatively.Three with complete relief and 4 with substantial relief.Only in 1 patient the pain remained unchangea.All patients demonstrated a negative seaphoid shift test on postoperative physical examination.The postoperative scores of the Modified Mayo Wrist Score and DASH questionnaire were significantly better than the pmopemtive scores according to the Wilcoxon signed-rank test(P＜0.05).Preoperative Mayo score was 51.3(30-70)while postoperative score was 78.1(45-95).DASH scors incteased from 39.3(18.3-49.3)preoperatively to 19.2(8.8-28.7)postoperatively. Conclusion This study suggests that arthroscopic radiofrequency shrinkage is a valid and safe procedure to treat partial intercarpal interosseous ligament injuries combined with TFCC injuries.