关节镜下治疗掌指、指间关节疾病的效果观察  

Curative Effect Observation in Micro-invasive Treatment of Metacarpophalangeal Joint and the Proximal Interphalangeal Joint Diseases under Small Arthroscope

作　　者：野战涛[1] 张卫平[1] 冯志军[1] 步建立[1] 刘长安[1] 

机构地区：[1]解放军白求恩国际和平医院骨科,石家庄050082

出　　处：《临床误诊误治》2012年第2期71-73,共3页Clinical Misdiagnosis & Mistherapy

摘　　要：目的观察小关节镜微创技术对手外伤患者掌指、指间关节疼痛、功能障碍等的治疗效果。方法对8例10个掌指、指间关节疾病的临床资料进行回顾性分析,其中近指间关节6个,掌指关节4个,在小关节镜监视下进一步了解掌指关节或指间关节病变,同时清理关节面增生的骨质、损伤的软骨、关节腔内的滑膜,松解关节囊、侧副韧带、掌板和肌腱,被动活动掌指或指间关节,观察临床效果。结果术后随访6～12个月,平均8个月。8例均未出现手术并发症和疼痛不适等症状,关节屈伸功能均有不同程度的改善,按手指屈伸功能总主动活动度(TAM)测定标准,主动活动范围优2例,良4例,中3例,差1例;被动活动范围优、良各4例,中2例。结论小关节镜下微创手术治疗掌指、指间关节疾病创伤小,治疗的准确性和针对性较高,术后恢复快。Objective To observe the therapeutic effect of micro-invasive surgery under small arthroscope for patients with functional handicap and pain of metacarpophalangeal joint and proximal interphalangeal joint after hand injury.Methods 8 patients（10 metacarpophalangeal and interphalangeal joint malfunction） were analyzed retrospectively in the study.The lesion was located at interphalangeal joints in 6 cases and at the metacarpophalangeal joints in 4 cases.Based on the small arthroscopic findings,the diseases of the metacarpophalangeal joint and the proximal interphalangeal joint were studied,the hyperplastic bone was cleared and scathing gristle,synovium in the joint,releasing joint capsule,collateral ligaments,volar plate and tendon,passive motion on the metacarpophalangeal joint and the proximal interphalangeal joint were attended to.Results The patients were followed up for 6-12 months with an average of 8 months postoperatively.Joint malfunction,pain and discomfort in all the patients were alleviated to some extent and in accordance with the scoring system of total active movement（TAM）,2 cases achieved excellent results,4 good,2 fair and 1 poor results of active range,and 4 cases achieved excellent and good results respectively,2 fair results of passive activity range.Conclusion Treatment of metacarpophalangeal and interphalangeal joint malfunction under small arthroscope has many advantages,such as being less invasive,more accurate and quick recovery.

关 键 词：掌指关节 关节疾病 关节镜 

分 类 号：R687.4[医药卫生—骨科学]