| 摘要: |
| 目的 探讨骨间膜远端斜束强化技术治疗下尺桡关节（DRUJ）不稳定的临床疗效。方法 回顾性分析2019年1月至2022年1月于我院接受骨间膜远端斜束强化技术治疗的24例DRUJ不稳定患者的临床资料，收集患者的年龄，手术部位，随访时间，术前及末次随访时的腕关节视觉模拟量表（VAS）评分、前臂旋前及旋后活动度、快速臂肩手功能障碍评分，术后并发症等。比较手术前后患者腕关节VAS评分及功能指标。结果 随访12～21个月，平均随访时间为（15.38±2.76）个月。术前腕关节VAS评分为4～8（6.13±1.08）分，末次随访时为1～3（1.25±0.53）分，较术前改善（P＜0.001）；术前前臂旋前及旋后活动度为95°～145°（120.83±14.35）°，末次随访时为145°～180°（175.21±6.51）°，较术前增大（P＜0.001）；术前快速臂肩手功能障碍评分为34～98（78.58±19.22）分，末次随访时为10～34（21.46±6.30）分，较术前下降（P＜0.001）。术后1例患者前臂旋前受限，1例存在DRUJ不稳定，经相应处理后恢复。所有患者均未出现因同种异体肌腱所致的排斥反应或感染，以及操作所致的重要神经和血管损伤。结论 骨间膜远端斜束强化技术临床效果满意，并发症发生率低，是一种安全、有效的DRUJ不稳定治疗方式。 |
| 关键词: 骨间膜 远端斜束 下尺桡关节 关节不稳定性 |
| DOI：10.16781/j.CN31-2187/R.20220828 |
| 投稿时间：2022-10-25修订日期：2023-12-14 |
| 基金项目: |
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| Clinical efficacy of distal oblique bundle reinforcement for distal radioulnar joint instability |
| LIU Yonggang,WU You* |
(Department of Orthopaedics, General Hospital of Southern Theater Command of PLA, Guangzhou 510010, Guangdong, China
*Corresponding author) |
| Abstract: |
| Objective To investigate the clinical efficacy of distal oblique bundle reinforcement for the treatment of distal radioulnar joint (DRUJ) instability. Methods The clinical data of 24 patients with DRUJ instability treated with distal oblique bundle reinforcement in our hospital from Jan. 2019 to Jan. 2022 were retrospectively analyzed. The age, surgical site, follow-up time, wrist visual analogue scale (VAS), range of motion (pronation＋supination) of forearm, the quick disabilities of the arm, shoulder and hand (QuickDASH) score before operation and at the last follow-up, and postoperative complications of the patients were collected. The wrist VAS scores and functional indexes were compared before and after operation. Results The average follow-up time was 12-21 (15.38±2.76) months. The wrist VAS score was 4-8 (6.13±1.08) before operation and 1-3 (1.25±0.53) at the last follow-up, showing improvement after operation (P＜0.001). The range of motion (pronation＋supination) of forearm was 95°-145° (120.83±14.35)° before operation and 145°-180° (175.21±6.51)° at the last follow-up, also showing increasement after operation (P＜0.001). The QuickDASH score was 34-98 (78.58±19.22) before operation and was 10-34 (21.46±6.30) at the last follow-up, with significant difference (P＜0.001). One patient had limited forearm pronation and 1 patient had DRUJ instability, which recovered after corresponding treatments. No patients had rejection or infection caused by allogeneic tendon, or important nerve and vascular injuries caused by operation. Conclusion The clinical effect of distal oblique bundle reinforcement is satisfactory, and the incidence of complications is low, indicating it is a safe and effective surgical method for DRUJ instability. |
| Key words: interosseous membrane distal oblique bundle distal radioulnar joint joint instability |
