转移部分桡侧腕屈肌腱重建舟月韧带治疗腕关节不稳疗效观察  

作　　者：周海波 张高孟[2] 黄显军 姜磊 郭征东 

机构地区：[1]浙江省荣军医院,314031 [2]上海华山医院,200040

出　　处：《浙江临床医学》2022年第11期1667-1669,共3页Zhejiang Clinical Medical Journal

摘　　要：目的观察转位移植部分桡侧腕屈肌腱重建舟月韧带治疗腕关节不稳的疗效。方法回顾性分析2010年9月至2019年8月采用转位移植部分桡侧腕屈肌腱重建舟月韧带的临床资料。结果本组6例(7手),术后伤口均愈合良好,术后6周取外固定,8周取内固定行腕关节功能锻炼,术后随访半年至一年,腕关节活动良好。结论采用移植部分桡侧腕屈肌腱重建舟月韧带,经背侧入路,避开掌侧神经、血管、肌腱等,在直视下复位各脱位的腕骨,并修复腕背侧韧带。经舟骨纵轴的骨隧道穿过转位肌腱,且在月骨近侧开骨槽并将肌腱通过锚钉固定于槽内,拉拢固定舟、月骨的同时提供轴心的稳定性,相当于一侧入路提供了掌、背双侧的稳定性,故该术式较传统手术具有一定优势。Objective To observe the curative effect of transposition and transplantation of partial radial wrist flexor tendon to reconstruct the scaphoid lunate ligament in the treatment of wrist instability.Methods From September 2010 to August 2019,7 cases treated with transposition and transplantation of partial radial wrist flexor tendon to reconstruct scaphoid lunate ligament were retrospectively analyzed.Results There were 6 patients(7 hands)in this group.The wounds healed well after operation.After surgery,external fixation was taken at 6 weeks and internal fixation was taken at 8 weeks for wrist function exercise.The wrist movement was good after medical follow-up for half a year to one year.Conclusion The scaphoid lunate ligament can be reconstructed by transplanting part of the radial wrist flexor tendon.The dorsal approach avoids the palmar nerves,blood vessels and tendons.It can also restore the dislocated carpal bones and repair the dorsal carpal ligament under direct vision.The bone tunnel passing through the longitudinal axis of navicular bone passes through the transposed tendon,and a bone groove is opened at the proximal side of lunate bone,and the tendon is fixed in the groove through anchor nails.Pulling and fixing the navicular and lunate bone provides the stability of the axis,which is equivalent to that one side approach provides the stability of palmar and dorsal sides.Therefore,this operation has certain advantages over traditional surgery.

关 键 词：部分桡侧腕屈肌腱 转移 重建 腕关节 

分 类 号：R687.2[医药卫生—骨科学]