腕关节镜技术对三角纤维软骨复合体Palmer分型损伤的诊治效果分析  

The Effect of Wrist Arthroscopy on the Diagnosis and Treatment of Triangular Fibrocartilage Complex Palmer Type Injury

作　　者：邹向前[1] 魏辉[1] 孔宪述[1] 张玲[1] ZOU Xiangqian;WEI Hui;KONG Xianshu;ZHANG Ling(The Third People’s Hospital of Dalian City,Liaoning Province,Dalian 116033,China)

机构地区：[1]辽宁省大连市第三人民医院,辽宁大连116033

出　　处：《中国医学创新》2022年第2期77-81,共5页Medical Innovation of China

摘　　要：目的:研究腕关节镜技术对三角纤维软骨复合体(TFCC)Palmer分型损伤的诊治效果。方法:选取2018年3月-2020年6月大连市第三人民医院收治的79例TFCC损伤患者作为研究对象,记作观察组,根据腕关节镜Palmer分型的差异,予以患者相应的腕关节镜治疗方案。其中ⅠA型与ⅠD型TFCC损伤患者选择腕关节镜下单纯清创处理;ⅠB型与ⅠC型TFCC损伤患者选择腕关节镜下修补缝合术治疗;Ⅱ型TFCC损伤患者选择腕关节镜下清创手术联合软骨成形术治疗。另选取2015年10月-2018年2月医院收治的70例TFCC损伤患者作为对照组,实施针刀松解术治疗。比较两组患者临床疗效和手术前后Mayo评分、疼痛情况、患侧手与健侧手握力比值以及腕关节活动度。结果:观察组及对照组术后Mayo评分均高于术前,且观察组术后Mayo评分高于对照组,差异均有统计学意义(P<0.05)。观察组治疗优良率为91.14%,高于对照组的78.57%,差异有统计学意义(P<0.05)。观察组术后VAS评分低于对照组,而患侧手与健侧手握力比值高于对照组,差异均有统计学意义(P<0.05)。观察组术后腕关节旋转活动度、桡尺偏角以及腕关节屈伸度均明显高于对照组,差异均有统计学意义(P<0.05)。结论:腕关节镜技术对TFCC分型损伤的诊疗效果较佳,具有微创、安全、有效的优势。Objective:To study the therapeutic effect of wrist arthroscopy in the diagnosis and treatment of triangular fibrocartilage complex(TFCC)Palmer type injury.Method:A total of 79 patients with TFCC injury admitted to the Third People’s Hospital of Dalian City from March 2018 to June 2020 were selected as the research subjects and recorded as the observation group.According to the difference of wrist arthroscopy Palmer classification,patients were given corresponding wrist arthroscopic treatment plan.Patients with typeⅠA and typeⅠD TFCC injury were treated by wrist arthroscopy,patients with typeⅠB and typeⅠC TFCC injury were treated with wrist arthroscopic repair and suture.Patients with typeⅡTFCC injury were treated with wrist arthroscopic debridement combined with chondroplasty.70 patients with TFCC injury admitted to our hospital from October 2015 to February 2018 were selected as the control group and treated with acumotomolysis.The clinical efficacy,Mayo clinic score,pain,grip strength ratio of affected hand to healthy hand,and range of motion of wrist before and after surgery between the two groups.Result:The Mayo scores after surgery in the observation group and the control group were higher than those before surgery,and the Mayo score after surgery in the observation group was higher than that in the control group,with statistical significances(P<0.05).The excellent and good rate of observation group was 91.14%,higher than 78.57%of control group,the difference was statistically significant(P<0.05).The VAS score of the observation group was lower than that of the control group,while the ratio of grip strength between the affected side and the healthy side was higher than that of the control group,with statistical significance(P<0.05).The rotatory range of motion,radial ulnar angle and wrist flexion and extension of the observation group were significantly higher than those of the control group,with statistical significances(P<0.05).Conclusion:Carpal arthroscopy has a better effect in the diagnosis

关 键 词：三角纤维软骨复合体 Palmer分型 腕关节镜 

分 类 号：R687.3[医药卫生—骨科学]