腕关节镜下经骨修复三角纤维软骨复合体损伤的疗效与影像学评价  

Effect and imaging evaluation of transosseous repair of triangular fibrocartilage complex injury in patients under wrist arthroscopy

作　　者：邓金丽 吴亮 沈莉娟 赵燕 DENG Jinli;WU Liang;SHEN Lijuan;ZHAO Yan(Linping Campus,Second Affiliated Hospital of Zhejiang University School of Medicine,Zhejiang 311103,China)

机构地区：[1]浙江大学医学院附属第二医院临平院区,杭州311103

出　　处：《浙江创伤外科》2025年第4期601-604,共4页Zhejiang Journal of Traumatic Surgery

摘　　要：目的分析腕关节镜下经骨修复三角纤维软骨复合体(TFCC)损伤的疗效与影像学评价。方法回顾性选取2019年1月至2023年1月本院收治的99例TFCC损伤患者为研究对象,均进行腕关节镜下经骨修复手术。比较术前、术后3个月、术后6个月和末次随访时的视觉模拟评分(VAS)、上肢功能评定量表(DASH)、腕关节功能患者自行评估量表(PRWE)评分、腕关节活动度、腕关节握力,采用影像学评估末次随访的手术结果。结果患者术后3个月、术后6个月和末次随访时的VAS评分均优于术前(均P<0.05);患者术后3个月的DASH、PRWE、腕关节屈伸、前臂旋转、尺桡偏活动度及腕关节握力与术前比较差异无统计学意义(均P>0.05);患者术后6个月和末次随访时的DASH、PRWE、腕关节屈伸、前臂旋转、尺桡偏活动度及腕关节握力均优于术前(均P<0.05);MRI结果显示,所有患者末次随访的TFCC连续性均存在,6例患者发生肌腱和桡尺神经的医源性损伤;X线片结果显示,所有患者末次随访时的远尺桡间距测量值优于术前(P<0.05)。结论腕关节镜下经骨修复TFCC损伤安全有效,能够缓解症状,促进腕部功能恢复。Objective To analyze the effect and imaging evaluation of transosseous repair of triangular fibrocartilage complex(TFCC)injury in patients under wrist arthroscopy.Methods 99 patients with TFCC injury treated in the our hospital from January 2019 to January 2023 were retrospectively selected as the study objects,and all of them were underwent wrist arthroscopic transosseous repair surgery.Visual analog Scale(VAS),Upper Limb Function Rating Scale(DASH),Patient Self-Assessment Scale of Wrist Function(PRWE),wrist range of motion and wrist grip strength were compared before surgery,3 months after surgery,6 months after surgery and at the last follow-up.Imaging was used to evaluate the surgical results at the last follow-up.Results The VAS at 3 months after surgery,6 months after surgery and last follow-up were better than those before surgery(P<0.05).There were no significant differences in DASH,PRWE,wrist flexion and extension,forearm rotation,radioulnar deviation motion and wrist grip strength 3 months after surgery(P>0.05).DASH,PRWE,wrist flexion and extension,forearm rotation,radio-ulnar deviation motion and wrist grip strength were all better than those before surgery at 6 months and the last follow-up(P<0.05).MRI results showed that TFCC continuity was present in all patients at the last follow-up,and iatrogenic injury of tendon and radioulnar nerve occurred in 6 patients.The radiographic results showed that the measurements of distal radio-ulnar distance in all patients at the last follow-up were better than those before surgery(P<0.05).Conclusion Wrist arthroscopic transosseous repair of TFCC injury is safe and effective,and can relieve symptoms and promote the recovery of wrist function.

关 键 词：三角纤维软骨复合体 关节镜 修复 影像学评价 

分 类 号：R687.3[医药卫生—骨科学]