摘要
目的介绍腕关节镜掌侧入路程式化建立的方法及其临床应用效果。方法采用“由内向外”和“由外向内”相结合，1／2入路进入关节镜，3／4入路进入交换棒；6U入路进入关节镜，4／5入路进入交换棒的程式建立腕关节镜掌桡侧和尺侧入路。临床采用掌侧入路腕关节镜下处理桡骨远端骨折和腕尺侧痛患者25例，了解入路对手术的效用和副损伤。结果通过腕关节镜掌侧入路，成功地进行了桡骨远端背侧骨折块的复位和内固定，对三角纤维软骨复合体的损伤进行评估和清创等手术，2例出现尺神经损伤症状，保守治疗后恢复，所有患者均无重要血管和肌腱的损伤。结论程式化建立腕关节镜掌侧入路，安全、快捷、有效。对于腕部某些部位的疾病，掌侧入路腕关节镜手术是一种必要的选择。
Objective To introduce a standardized protocol to establish volar portals in wrist arthroscopy and to evaluate their clinical applications. Methods The radiovolar portal was established with arthrescopic monitor through 1/2 portal and switching stick through 3/4 portal, while the ulnovolar portal was established with arthroscopic monitor through 6U portal and switching stick through 4/5 portal. The ＂Inside-out＂ and ＂Outside-in＂ arthrescopic portal establishing techniques were combined to the portal establistment. Twenty-five cases of distal radius fractures or ulnar-side wrist pains were treated with arthroscopy through volar portals established with the above protocol, of which the efficiency and complications were evaluated. Results The fragments of distal radius end were reduced and freed, and the triangular fibrocartilage complex （TFCC） was examined and debfided successfully through volar portals. The symptom of unlar nerve injury occurred in two patients and then recovered after conservative treatment. No permanent complication of vessels and tendons were found in our cases. Conclusion Our procedures for the establishment of volar wrist arthrescopic portals were safe and effective, with which some wrist disorders could be explored much further.
出处
《中华手外科杂志》
CSCD
北大核心
2012年第3期148-150,共3页
Chinese Journal of Hand Surgery
基金
国家自然科学基金资助项目（81071479）,江苏省卫生厅“科教兴卫工程”重点人才基金资助项目（RC2011101）
关键词
腕关节
关节镜
入路
掌侧
Carpal joints
Arthroscopes
Portal
Volar
