关节镜下腕关节囊外透骨修复三角纤维软骨复合体深层止点损伤  

Arthroscopic repair of deep insertion injury of triangular fibrocartilage complex by bone penetration outside wrist joint capsule

作　　者：于宁[1] 王彦生[1] 刘波[2] 许蕙[1] 叶放[1] Yu Ning;Wang Yansheng;Liu Bo;Xu Hui;Ye Fang(Department of Hand Surgery,Affiliated Central Hospital of Shenyang Medical College,Shenyang 110024,China;Department of Hand Surgery,Beijing Jishuitan Hospital,Beijing 100035,China)

机构地区：[1]沈阳医学院附属中心医院手外五科,沈阳110024 [2]北京积水潭医院手外科,北京100035

出　　处：《中华手外科杂志》2022年第6期511-515,共5页Chinese Journal of Hand Surgery

摘　　要：目的探讨应用腕关节镜下腕关节囊外尺骨透骨缝合技术修复三角纤维软骨复合体(triangular fibrocartilage complex,TFCC)深层止点撕裂的疗效。方法自2017年5月至2020年9月我科通过腕关节镜诊断ⅠB型TFCC损伤伴有桡尺远侧关节(distal radioulnar joint,DRUJ)关节不稳定患者25例。采用腕关节镜下腕关节囊外透骨缝合技术,根据Mayo腕关节评分系统、DASH评分、VAS疼痛评分和手术后DRUJ关节稳定性检查等方面评价手术效果。结果25例患者术后随访12~36个月,平均18个月。本术式可以有效修复TFCC损伤。DRUJ评分,术前平均3.5,术后10;VAS评分,术前平均5.0术后1.0;DASH评分,术前平均36,术后9;Mayo评分,术前平均87,术后60。术后效果优15例,好6例,良3例,差1例。结论应用腕关节镜下腕关节囊外透骨缝合技术修复TFCC隐窝止点撕裂是一种安全、有效、可靠的修复方法。Objective To investigate the clinical efficacy of repairing deep insertion point tear of triangular fibrocartilage complex(TFCC)with ulnar suture outside the capsule of wrist joint under wrist arthroscope.Methods From May 2017 to September 2020,25 patients with typeⅠB TFCC injury and distal radioulnar joint(DRUJ)instability were diagnosed by wrist arthroscopy in our department.The operation effect was evaluated according to Mayo wrist scoring system,DASH score,VAS pain score and DRUJ stability examination after the operation.Results Twenty-five patients were follow-up for 12 to 36 months,with an average of 18 months.This operation can effectively repair TFCC injury.DRUJ score averaged 3.5 preoperatively,10 postoperatively.VAS score averaged 5.0 preoperatively,1.0 postoperatively.DASH score averaged 36 preoperatively and 9 postoperatively.Mayo score averaged 87 preoperatively,60 postoperatively.The postoperative results were excellent in 15 cases,good in 6 cases,good in 3 cases and poor in 1 case.Conclusion It is a safe,effective and reliable method to repair the laceration of TFCC foveal insertion with the technique of penetrating bone suture outside the wrist joint capsule under wrist arthroscope.

关 键 词：腕关节 关节镜 三角纤维软骨复合体 

分 类 号：R687.4[医药卫生—骨科学]