儿童和青少年创伤性TFCC病变-以前被忽视的伤害?]

Kristofer Wintges, Dirk Sommerfeldt, Hauke Rüther
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引用次数: 0

摘要

虽然三角纤维软骨复合物(TFCC)损伤在儿童和青少年中比在成人中更少见,但可导致远端尺桡关节(DRUJ)的慢性疼痛和不稳定,最终使个体易患长期骨关节炎。高能创伤后桡骨远端骨折脱位伴尺骨茎突撕脱是TFCC损伤的危险因素。诊断包括彻底的临床检查和成像程序,如X射线和磁共振成像(MRI)。如果DRUJ没有不稳定,保守治疗在大多数情况下是成功的。然而,如果DRUJ不稳定或保守治疗3个月后没有改善,则需要进行腕部关节镜诊断以进一步诊断并同时治疗。根据年龄和损伤程度的不同,可采用不同的手术技术,如经囊或经骨再固定。早期诊断和治疗对于消除疼痛、稳定的DRUJ和恢复体育活动至关重要。在我们自己的病人中,12名儿童和青少年表现出很好的效果,没有严重的并发症。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Traumatic TFCC lesions in childhood and adolescence-A previously neglected injury?]

Although injuries to the triangular fibrocartilage complex (TFCC) are less common in children and adolescents than in adults, can lead to chronic pain and instability in the distal radioulnar joint (DRUJ), ultimately predisposing individuals to long-term osteoarthritis. A dislocated distal radius fracture with avulsion of the styloid process of the ulna following high-energy trauma is a risk factor for a TFCC injury. The diagnostics include a thorough clinical examination and imaging procedures, such as X‑ray and magnetic resonance imaging (MRI). If there is no instability of the DRUJ, conservative treatment can be successful in most cases. However, if there is instability of the DRUJ or if there is no improvement after 3 months of conservative treatment, diagnostic arthroscopy of the wrist is indicated for further diagnostics and concurrent treatment. Depending on the age and extent of the injury, various surgical techniques can be used, such as transcapsular or transosseous refixation. Early diagnosis and treatment are essential to achieve freedom from pain, a stable DRUJ and enable a return to sports activities. In our own patient collective 12 children and adolescents showed very good results with no major complications.

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