残留软骨切下回植治疗手外伤后指间关节部分软骨缺损的临床疗效  

Replantation of the remaining part of articular cartilage treating partial interphalangeal cartilage defect

作　　者：龙文浩[1] 蓝映 封帆[1] 王伟明[1] 苏奕轩 LONG Wen-hao;LAN Ying;FENG Fan;WANG Wei-ming;SU Yi-xuan(Department of Hand Surgery,Humen Hospital of Dongguan City,Dongguan 523902,China)

机构地区：[1]东莞市虎门医院手外科,广东东莞523902

出　　处：《岭南现代临床外科》2021年第1期117-119,共3页Lingnan Modern Clinics in Surgery

摘　　要：目的探讨残余软骨切下回植治疗指间关节部分软骨缺损的临床疗效。方法自2012年6月至2019年8月共收治指间关节面部分软骨质缺损患者16例(16指),近侧指间关节5例,远侧指间关节11例,切下残留软骨(残留达半面或以上)回植治疗重建指间关节,术后对指关节稳定性,外观、功能恢复等指标进行分析评估。结果术后随访12~60个月,平均36个月,均未发现软骨坏死,指间关节侧弯畸形充分矫正,关节僵硬改善较好,侧弯面软组织挛缩得到有效改善,外观基本恢复。近侧指间关节屈曲达60°~90°,远侧指间关节屈曲达40°~80°。按照中华医学会手外科学会上肢部分功能评定试用标准进行评定,优10例,良3例,可3例,优良率达到81.25%。结论残留软骨回植治疗指间关节部分软骨缺损可部分重建关节功能,临床疗效满意。Objective To investigate the clinical effect of replantation of the remaining part of articular cartilage treating partial interphalangeal cartilage defect.Methods From 2010 June to 2019 August,16 cases(16 interphalangeal joints)with partial articular cartilage defects,were reviewed and analyzed.And then,5 were proximal interphalangeal joints and 11 were distal interphalangeal joints.All cases were treated by removing the retained cartilage(the proportion reached at least half the articular facet)and then replanting it.After the surgeries,the stability,the appearance,the joint function were evaluated.Results 16 patients were followed 12 to 60 months(mean 36 months).No cartilage necrosis was found.The lateral angulation deformities were corrected.The stiffness of the joints and the contracture of the soft tissue were alleviated.The range of motion of the proximal interphalangeal joints was ranged from 60 degrees to 90 degrees,while the distal interphalangeal joints from 40 degrees to 80 degrees.According to the Criteria of Upper Limb Function Evaluation by Chinese Society of Hand Surgery,the cases were ranked excellent 10 cases,good 3 cases,fair 3 cases,the excellent/good rate reached 81.25%.Conclusion Replantation of the remaining part of articular cartilage treating partial interphalangeal cartilage defect can achieve favorable clinical results.

关 键 词：指间关节 软骨缺损 回植 疗效 

分 类 号：R683[医药卫生—骨科学]