CAJ | 학술논문

目的探讨腕关节镜下滑膜切除术治疗慢性腕关节炎的方法及疗效.方法 2011年11月至2014年3月采用腕关节镜下滑膜切除术治疗慢性腕关节炎33例,术前术后采用改良Mayo腕关节评分及DASH量表评价腕关节镜下滑膜切除术治疗慢性腕关节炎的疗效.结果术后所有患者均获得随访,随访时间为7～26个月(平均19.7个月).术前患侧握力平均为健侧的59.6％(43.2％～ 68.4％),术后平均为78.2％(66.2％～ 89.7％).腕关节屈伸范围术前为(76.0±16.0)°,术后为(116.0±18.0)°,尺桡偏术前为(22.0±11.0)°,术后为(42.0±14.0)°;腕关节旋前、旋后活动度术前为(128.0± 18.0)°,术后为(149.0±22.0)°.改良Mayo腕关节评分术前平均为46.7(33 ～ 69),术后平均为80.5(56～95).DASH量表评分术前平均为42.4(22～53),术后平均为18.2 (12～ 38).改良Mayo腕关节评分及DASH量表评分术后较术前均有明显改善(P＜0.05).结论关节镜下滑膜切除术治疗慢性腕关节炎具有微创,术后恢复快,疗效较好等优点.
목적 탐토완관절경하활막절제술치료만성완관절염적방법급료효.방법 2011년11월지2014년3월채용완관절경하활막절제술치료만성완관절염33례,술전술후채용개량Mayo완관절평분급DASH량표평개완관절경하활막절제술치료만성완관절염적료효.결과 술후소유환자균획득수방,수방시간위7～26개월(평균19.7개월).술전환측악력평균위건측적59.6％(43.2％～ 68.4％),술후평균위78.2％(66.2％～ 89.7％).완관절굴신범위술전위(76.0±16.0)°,술후위(116.0±18.0)°,척뇨편술전위(22.0±11.0)°,술후위(42.0±14.0)°;완관절선전、선후활동도술전위(128.0± 18.0)°,술후위(149.0±22.0)°.개량Mayo완관절평분술전평균위46.7(33 ～ 69),술후평균위80.5(56～95).DASH량표평분술전평균위42.4(22～53),술후평균위18.2 (12～ 38).개량Mayo완관절평분급DASH량표평분술후교술전균유명현개선(P＜0.05).결론 관절경하활막절제술치료만성완관절염구유미창,술후회복쾌,료효교호등우점.
Objective To explore the application and efficacy of arthroscopic synovectomy in the treatment of chronic wrist arthritis.Methods Thirty-three patients with chronic wrist arthritis were treated with arthroscopic synovectomy.The modified Mayo Wrist Score and DSAH questionnaire were applied to evaluate the preoperative and postoperative function of the patients.Results All patients were follow-up for 7 to 26 months.The average follow-up time was 19.7 months.The preoperative grip strength was 59.6％ (range,43.2％ to 68.4％) of that of the contralateral side.Postoperatively grip strength increased to 78.2％ (range,66.2％ to 89.7％) of the normal side.Wrist flexion and extension range was (76.0 ± 16.0)° preoperatively and (116.0 ± 18.0)° postoperatively.Range of motion of ulnar and radial deviation was (22.0 ± 11.0)°preoperatively and (42.0 ± 14.0)° postoperatively.Forearm rotation was(128.0 ± 18.0)° preoperatively and (149.0± 22.0)° postoperatively.Preoperative Mayo wrist score was 46.7 on average (range,33 to 69),while postoperative Mayo wrist score was 80.5 on average (range,56 to 95).DASH score increased from 42.4 (range,22 to 53) preoperatively to 18.2 (range,12 to 38) postoperatively.According to the Wilcoxon signedrank test,there were significant statistical differences between the postoperative and preoperative modified Mayo Wrist scores and DASH questionnaire scores (P ＜ 0.05).Conclusion Arthroscopic synovectomy was an minimally invasive and effective method for the treatment of chronic wrist arthritis.