全部 标题 作者
关键词 摘要

OALib Journal期刊
ISSN: 2333-9721
费用:99美元

查看量下载量

相关文章

更多...
-  2017 

Sauvé-Kapandji 术治疗创伤性尺骨茎突撞击综合征

DOI: doi:10.7507/1002-1892.201607041

Keywords: 尺骨茎突撞击综合征, Sauvé-Kapandji术, 腕关节, 功能重建

Full-Text   Cite this paper   Add to My Lib

Abstract:

目的 探讨Sauvé-Kapandji术治疗创伤性尺骨茎突撞击综合征的临床疗效。 方法 2010 年 6 月–2013 年 1 月,采用 Sauvé-Kapandji 术治疗12例创伤性尺骨茎突撞击综合征患者。男 4 例,女 8 例;年龄 50~69 岁,平均 58.9 岁。致伤原因:交通事故伤 1 例,摔伤 11 例。患者均有下尺桡关节脱位,其中 7 例合并桡骨远端陈旧性骨折。主要临床症状为腕尺侧疼痛伴功能受限;疼痛视觉模拟评分(VAS)为(6.2±1.4)分。病程 2~4 个月,平均 3.5 个月。术后采用 VAS 评价腕关节疼痛程度,记录腕关节活动度、握力、Evans 评分,摄腕关节 X 线片观察。 结果 术后切口均Ⅰ期愈合,无感染及神经、血管损伤等相关并发症发生。12 例患者均获随访,随访时间 37~73 个月,平均 58.4 个月。末次随访时,腕关节VAS评分为(1.2±1.0)分,与术前比较差异有统计学意义(t=9.950,P=0.000)。患侧腕关节掌屈、背伸、尺偏以及前臂旋前、旋后活动度均明显改善,但仍显著低于健侧(P<0.05);握力及腕关节功能Evans评分与健侧比较,差异均无统计学意义(t=–0.885,P=0.386;t=–1.969,P=0.062)。腕关节功能评分获优 8 例,良 3 例,中 1 例,优良率 91.7%。X 线片复查示,下尺桡关节均获骨性融合,融合时间 3~6 个月,平均 3.5 个月。3 例出现尺骨截骨处尺骨近端不稳。 结论 对于创伤性尺骨茎突撞击综合征,Sauvé-Kapandji 手术是一种可靠补救方法,术后患者腕关节疼痛有效缓解,前臂旋转功能得到较大改善,但需要严格把握手术适应证

References

[1]  13. Malone PS, Cooley J, Morris J, et al. The biomechanical and functional relationships of the proximal radioulnar joint, distal radioulnar joint, and interosseous ligament. J Hand Surg (Eur Vol), 2015, 40(5): 485-493.
[2]  15. Daecke W, Martini AK, Streich NA. Kapandji-Sauvé procedure for chronic disorders of the distal radioulnar joint with special regard to the long-term results. Handchir Mikrochir Plast Chir, 2003, 35(3): 164-169.
[3]  16. Czermak C, Wittemann M, Germann G, et al. Functional results after the Kapandji-Sauvé operation for salvage of the distal radioulnar joint. Handchir Mikrochir Plast Chir, 2007, 39(6): 403-408.
[4]  17. Ross M, Thomas J, Couzens G, et al. Salvage of the unstable Sauvé-Kapandji procedure: a new technique. Tech Hand Up Extrem Surg, 2007, 11(1): 87-92.
[5]  18. Zimmermann R, Gabl M, Angermann P, et al. Long-term results after a modified Sauvé-Kapandji procedure. Report on 105 post-traumatic cases. Unfallchirurg, 2003, 106(7): 561-565.
[6]  19. 王云亭, 林朋, 史振才, 等. Sauvé-Kapandji 手术治疗桡尺远侧关节脱位的疗效. 中华手外科杂志, 2000, 16(3): 146-148.
[7]  1. Doherty C, Gan BS, Grewal R. Ulnar shortening osteotomy for ulnar impaction syndrome. J Wrist Surg, 2014, 3(2): 85-90.
[8]  2. 陈君蓉, 但倩, 张滔, 等. X线平片、CT、MRI对尺骨撞击综合征的对照研究. 华西医学, 2015, 30(3): 488-491.
[9]  3. Lee SK, Kim KJ, Cha YH, et al. Conservative treatment is sufficient for acute distal radioulnar joint instability with distal radius fracture. Ann Plast Surg, 2016, 77(3): 297-304.
[10]  4. Barbaric K, Rujevcan G, Labas M, et al. Ulnar shortening osteotomy after distal radius fracture malunion: review of literature. Open Orthop J, 2015, 9: 98-106.
[11]  5. 夏平光, 蔡贤华, 王庆, 等. 桡尺韧带关节内重建术治疗桡尺远侧关节陈旧性脱位. 中国修复重建外科杂志, 2014, 28(2): 205-208.
[12]  6. Reissner L, B?ttger K, Klein HJ, et al. Midterm results of semiconstrained distal radioulnar joint arthroplasty and analysis of complications. J Wrist Surg, 2016, 5(4): 290-296.
[13]  14. Malone PS, Cooley J, Terenghi G, et al. The effect of elbow extension on the biomechanics of the osseoligamentous structures of the forearm. J Hand Surg (Am), 2015, 40(9): 1776-1784.
[14]  7. Haferkamp H. Kapandji-Sauvé procedure with distal radioulnar fusion and segmental resection of the ulna. Oper Orthop Traumatol, 2012, 24(1): 13-22.
[15]  8. 唐诗添, 刘刚, 张定伟, 等. 带血管蒂头状骨瓣移位治疗终末期月骨缺血性坏死的远期疗效. 中国修复重建外科杂志, 2014, 28(8): 925-928.
[16]  9. 陈振兵, 洪光祥, 王发斌. 上肢功能评定表. 中国修复重建外科杂志, 2004, 18(6): 520-521.
[17]  10. McGinley JC, Gold G, Cheung E, et al. MRI detection of forearm soft tissue injuries with radial head fractures. Hand (NY), 2014, 9(1): 87-92.
[18]  11. Daneshvar P, Willing R, Pahuta M, et al. Osseous anatomy of the distal radioulnar joint: an assessment using 3-dimensional modeling and clinical implications. J Hand Surg (Am), 2016, 41(11): 1071-1079.
[19]  12. Malone PS, Shaw OG, Lees VC. Anatomic relationships of the distal and proximal radioulnar joints articulating surface areas and of the radius and ulna bone volumes-implications for biomechanical studies of the distal and proximal radioulnar joints and forearm bones. Front Bioeng Biotechnol, 2016, 4: 61.

Full-Text

Contact Us

service@oalib.com

QQ:3279437679

WhatsApp +8615387084133