Tendon ball arthroplasty and proximal carpal stabilization with tendon graft for advanced Kienböck's disease.

Wen Zhang, Peng Hou, Tianyi Wu, Pak-Cheong Ho, Luyuan Sun, Chunyang Wang
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Abstract

This study reports the surgical technique and outcomes of tendon ball arthroplasty combined with proximal carpal stabilization using the extensor carpi radialis longus tendon for treating advanced Kienböck's disease. The collapsed lunate is excised and a tendon ball inserted as a spacer. A distally based extensor carpi radials longus graft is passed through the scaphoid, tendon ball and triquetrum, reconstructing the proximal carpal row. In total, 16 patients were included and the mean follow-up was 25 months. Pain improved from 5.6 preoperatively to 1.3 postoperatively on a 10-point visual analogue scale. Mean wrist motion improved by 17.8° and grip strength compared with the non-operative side increased by 22.1% on average. Radiographic outcomes demonstrated correction of scaphoid flexion and carpal height ratio. The modified tendon ball arthroplasty may be an alternative wrist salvage procedure for the treatment of advanced Kienböck's disease.Level of evidence: IV.

肌腱球关节成形术和腕骨近端肌腱移植稳定术治疗晚期 Kienbock 病。
本研究报告了腱球关节置换术结合腕伸肌腱近端稳定术治疗晚期基恩博克病的手术技巧和效果。切除塌陷的月骨,插入腱球作为间隔。通过肩胛骨、肌腱球和三棱肌,在远端植入桡侧长伸肌腱,重建腕骨近端。共纳入了 16 名患者,平均随访时间为 25 个月。根据 10 点视觉模拟评分法,疼痛从术前的 5.6 改善到术后的 1.3。与非手术侧相比,平均腕关节活动度增加了17.8°,握力平均增加了22.1%。影像学结果显示,肩胛骨屈度和腕高比得到了矫正。改良腱球关节置换术可能是治疗晚期基恩博克病的另一种腕关节救治方法:证据等级:IV。
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