吊床法联合Mini TightRope®治疗拇指手掌骨关节病的短期效果

IF 0.5 Q4 SURGERY
Ikuo Nakai, Denju Osada
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引用次数: 0

摘要

背景:利用拇外展长肌腱(APL)治疗高级拇指腕掌骨(CMC)关节的悬吊关节成形术被称为吊床方法。我们回顾性研究了之前尝试使用该方法结合Mini TightRope®来改善CMC关节稳定性的短期结果。方法:纳入19例22手患者(男4例,女15例;平均年龄:61.7岁),原发性晚期拇指CMC关节病,在过去4年内接受了该手术。所有患者均为Eaton II-IV期拇指CMC关节炎。Mini TightRope®在APL肌腱固定掌骨前插入。固定2周后,允许患者无限制地使用手。我们评估了抓地力和握力;桡骨和掌骨外展角;手臂、肩部和手的快速残疾(quick DASH),手20分和Kapandji得分;术前和最后随访时的斜方高度;术后并发症及手术时间。结果:平均随访24.2个月,平均手术时间58.1分钟。术后握力、尖捏力、侧捏力增强。此外,桡骨和掌侧外展角得到改善。Kapandji、quick DASH和hand 20得分均有所提高。术前平均水平为8.4 mm,最终随访时平均水平为6.4 mm。术后并发症包括桡浅神经病变(n = 3)、拇指屈肌腱炎(n = 2)和桡侧腕屈肌腱炎(n = 3)。结论:吊床法联合Mini TightRope®短期效果良好。证据等级:IV级(治疗性)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Short-Term Results of the Hammock Method Combined with the Mini TightRope® for Thumb Carpometacarpal Arthrosis.

Background: Suspension arthroplasty using the abductor pollicis longus (APL) tendon for advanced thumb carpometacarpal (CMC) arthrosis is known as the hammock method. We retrospectively investigated the short-term results of a previous attempt to use this method combined with the Mini TightRope® to improve CMC joint stability. Methods: We included 22 hands of 19 patients (4 men and 15 women; mean age: 61.7 years) with primary advanced thumb CMC arthrosis who underwent this procedure during the past 4 years. All patients had Eaton stages II-IV thumb CMC arthritis. The Mini TightRope® was inserted before APL tendon fixation to the metacarpal bone. After a 2-week immobilisation, the patients were permitted unrestricted hand usage. We assessed the grip and pinch strength; radial and volar abduction angles; the quick disabilities of the arm, shoulder and hand (quick DASH), hand 20 and Kapandji scores; trapezial height before surgery and at the final follow-up; postoperative complications and operative time. Results: The mean follow-up was 24.2 months, and the mean operative time was 58.1 minutes. The grip, tip pinch and side pinch strengths increased postoperatively. Additionally, the radial and volar abduction angles improved. The Kapandji, quick DASH and hand 20 scores showed improvements. The mean trapezial height was 8.4 mm preoperatively and 6.4 mm at the final follow-up. Postoperative complications included superficial radial neuropathy (n = 3), thumb flexor tendinitis (n = 2) and flexor carpi radialis (FCR) tendinitis (n = 3). Conclusions: The hammock method combined with the Mini TightRope® shows good short-term results. Level of Evidence: Level IV (Therapeutic).

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来源期刊
CiteScore
0.90
自引率
0.00%
发文量
304
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