关节镜下经双骨隧道行腕三角纤维软骨复合体小凹止点重建的疗效观察  

Observation of the Therapeutic Effect of Arthroscopic Reconstruction of the Lunate Attachment of the Triangular Fibrocartilage Complex through Double Bone Tunnels

作　　者：田勇 田江波 武艺龙 董家赫 尚万山 张海龙 王孝辉 TIAN Yong;TIAN Jiangbo;WU Yilong;DONG Jiahe;SHANG Wanshan;ZHANG Hailong;WANG Xiaohui(Graduate School,Henan University of Chinese Medicine,Zhengzhou 450046,China;Luoyang Orthopedic-Traumatological Hospital of Henan Province(Henan Provincial Orthopedic Hospital),Luoyang 471002,Henan China)

机构地区：[1]河南中医药大学研究生院,郑州450046 [2]河南省洛阳正骨医院(河南省骨科医院)

出　　处：《中国中医骨伤科杂志》2025年第3期76-80,共5页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：洛阳市科技发展计划项目(2202010A)。

摘　　要：目的:观察经双骨隧道缝合治疗的三角纤维软骨复合体(TFCC)损伤(Atzei 2型)对腕关节功能的影响。方法:回顾性分析2018年3月至2022年6月收治且符合纳入标准的38例经双骨隧道行小凹止点重建术的三角纤维软骨复合体损伤(Atzei 2型)患者的临床资料。其中男20例,女18例;年龄为19~40岁,平均为(30.26±4.90)岁。记录所有患者术前、术后6个月和12个月,腕关节屈伸、旋转偏、尺桡偏活动度及握力,术后12个月采用Mayo腕关节功能评分评价疗效。结果:所有患者均获得有效随访,随访时间为12~18个月。术后6个月及12个月,患者的平均腕关节屈伸活动度、旋转偏活动度、尺桡偏活动度及握力均优于术前,差异均有统计学意义(P<0.05);术后前6个月患者平均腕关节屈伸、旋转、尺桡偏活动度变化均优于术后6~12个月变化,差异有统计学意义(P<0.05)。Mayo腕关节功能评分:优15例,良20例,可3例,差0例,优良率为92.11%。结论:对于三角纤维软骨复合体(Atzei 2型)损伤,经双骨隧道行小凹止点重建术后的早期腕关节功能恢复良好,有操作简单、手术时间短等优点。Objective:To assess the impact of repair of triangular fibrocartilage complex(TFCC)injuries(Atzei typeⅡ)via a double bone tunnel suture technique on wrist joint function.Methods:A retrospective analysis was conducted on the clinical data of 38 patients with TFCC injuries(Atzei typeⅡ)who underwent a foveal avulsion reconstruction surgery through a double bone tunnel from March 2018 to June 2022.The study included 20 males and 18 females,with an age range of 19 to 40 years old and a mean age of(30.26±4.90)years old.Preoperative and postoperative wrist flexion-extension,pronation-supination,ulnar-radial deviation,and grip strength were recorded at 6 and 12 months.The Mayo wrist score was used to evaluate the efficacy at 12 months postoperatively.Results:All patients were followed up effectively,with a follow-up period ranging from 12 to 18 months.At 6 and 12 months postoperatively,the mean wrist flexion-extension,pronation-supination,ulnar-radial deviation,and grip strength were all significantly better than preoperatively(P<0.05).The changes in wrist flexion-extension,pronation-supination,and ulnar-radial deviation during the first 6 months postop-eratively were significantly better than those between 6 and 12 months postoperatively(P<0.05).The Mayo wrist scores were as follows:excellent in 15 cases,good in 20 cases,fair in 3 cases,and poor in 0 cases,with a satisfactory rate of 92.11%.Conclusion:For TFCC injuries(Atzei typeⅡ),early wrist joint function recovery after foveal avulsion reconstruction surgery through a double bone tunnel is good,with the advantages of a simple procedure and short operation time.

关 键 词：三角纤维软骨复合体 关节镜 双骨隧道 小凹止点重建 

分 类 号：R687[医药卫生—骨科学]