团状掌长肌肌腱填塞治疗月骨缺血性坏死  

Replacement with mass autograft of palmaris longus tendon for acascular necrosis of the lunate

作　　者：李成明 肖驰 杨鑫宇 朱奕琳 于晓光[1] 崔大平[1] LI Cheng-ming;XIAO Chi;YANG Xin-yu;ZHU Yi-lin;YU Xiao-guang;CUI Da-ping(Department of Orthopedics,Zhongshan Hospital,Dalian University,Dalian 116001,China)

机构地区：[1]大连大学附属中山医院骨科,辽宁大连116001

出　　处：《中国矫形外科杂志》2023年第11期1024-1027,共4页Orthopedic Journal of China

基　　金：白求恩公益基金会项目(编号:X-J-2020-020)。

摘　　要：[目的]介绍团状掌长肌肌腱填塞治疗月骨缺血性坏死的手术技术和初步效果。[方法]2019年5月-2022年5月对8例月骨缺血性坏死患者采用月骨切除团状掌长肌肌腱填塞治疗。行腕关节掌侧弧形切口,彻底切除坏死月骨,将制备的团状掌长肌肌腱移植物填塞于月骨缺损处。[结果]所有病例均顺利完成手术,无严重并发症,随访12个月以上。VAS评分由术前(5.5±0.9)分显著降至末次随访时(0.3±0.4)分。腕关节活动范围较术前改善。手腕、手指肌力较术前相比均有1~2级的提升。末次随访时Mayo评分为(91.1±3.3)分,优良率100%。影像检查见,各腕骨无移位现象,排列结构正常。[结论]团状掌长肌腱移植物填塞至月骨缺损区,可替代月骨的支撑作用。该术式操作简单,初步效果满意。[Objective]To introduce the surgical technique and preliminary results of replacement with a mass autograft of palmaris lon-gus tendon for defect secondary to lunate resection for avascular necrosis of the lunate.[Methods]From May 2019 to May 2022,8 patients underwent lunate resection and replacement with mass autograft of palmaris longus tendon for avascular necrosis of the lunate.After a carpal arc-shaped incision was made,the necrotic lunate was exposed and removed completely.The palmaris longus tendon was harvested and pre-pared to a mass graft,and then implanted into the defect.[Results]All the 8 patients had operation performed successfully without serious complications,and were followed up for more than 12 months.The VAS score significantly decreased from(5.5±0.9)before surgery to(0.3±O.4)at the last follow-up,with a significantly improvement in wrist range of motion postoperatively.In addition,the muscle strength of wrist and finger improved by 1~2 degrees at the latest follow up compared with those before operation.The Mayo score was(91.1+3.3)at the last follow-up,with the excellent and good rate of 100%.In term of imaging examination,there was no displacement of carpal bones with normal arrangement of the structures till the latest follow up.[Conclusion]This mass autograft of palmaris longus tendon might replace the support-ing function of lunate,has benefits of simple operation,and does achieve satisfactory preliminary results.

关 键 词：月骨缺血性坏死 月骨切除 掌长肌肌腱 团状移植物 

分 类 号：R681.7[医药卫生—骨科学]