摘要
目的:探讨采用可调节带袢钛板交叉弹性固定治疗可手法闭合复位的陈旧性下尺桡关节脱位的微创手术技术要点及临床效果,为治疗陈旧性下尺桡关节脱位的手术选择提供参考。方法:回顾性分析2021年1月至2024年3月中国人民解放军东部战区总医院采用可调节带袢钛板交叉弹性固定治疗的接受手法闭合复位的6例陈旧性下尺桡关节脱位患者的临床资料。记录患者的既往病史、脱位类型、外伤至手术时间、术前及末次随访Cooney腕关节评分和末次随访Gartland-Werley腕关节评分。结果:共纳入6例患者,其中女5例,男1例;年龄23~52岁,平均(38.0±10.4)岁。所有患者均为陈旧性下尺桡关节脱位,且均由单纯型脱位迁延形成,从受伤至手术时间为9~17周,平均(11.7±3.3)周。术后即刻及末次随访X线检查均示下尺桡关节复位效果满意,内固定位置满意。6例患者均获得至少12个月随访,末次随访Cooney腕关节评分为(86.7±3.6)分,较术前(46.7±2.5)分有明显改善(P<0.001)。末次随访时,6例患者的Gartland-Werley腕关节评分均为优。术后无一例复发脱位。结论:陈旧性下尺桡关节脱位存在手法闭合复位的可能性。可调节带袢钛板交叉弹性固定是治疗可手法闭合复位陈旧性下尺桡关节脱位的一种有效的微创手术方式。
Objective:To investigate the key techniques and clinical outcomes of minimally invasive treatment using adjustable loop titanium plates with cross-elastic fixation for patients with chronic distal radioulnar joint(DRUJ)dislocation amenable to closed manual reduction,and to provide a reference for surgical decision-making in the management of chronic DRUJ dislocation.Methods:A retrospective analysis was conducted on six patients with chronic DRUJ dislocation who underwent closed manual reduction followed by cross-elastic fixation using adjustable loop titanium plates at the General Hospital of the Eastern Theater Command of the Chinese People's Liberation Army from January 2021 to March 2024.Clinical data,including medical history,dislocation type,interval from injury to surgery,preoperative and final follow-up Cooney wrist scores,and the final follow-up Gartland-Werley score,were recorded.Results:The study included six patients(five females and one male),with an age range from 23 to 52 years(mean age:38.0±10.4 years).All patients presented with chronic DRUJ dislocations,and all were of the dorsal ulnar dislocation pattern.The interval from injury to surgery ranged from 9 to 17 weeks,with a mean duration of 11.7±3.3 weeks.Postoperative and final follow-up X-ray examinations demonstrated satisfactory reduction of the DRUJ and stable internal fixation in all patients.All patients were followed for at least 12 months.The wrist Cooney score at the final follow-up was 86.7±3.6,showing significant improvement compared with the preoperative score of 46.7±2.5(P<0.001).According to the Gartland-Werley score,all six cases achieved an excellent outcome at the final follow-up,with no cases of recurrent dislocation.Conclusions:Chronic DRUJ dislocations may be amenable to closed manual reduction.Cross-elastic fixation using adjustable loop titanium plates represents an effective minimally invasive surgical approach for the treatment of reducible chronic DRUJ dislocation.
作者
常梦寒
张军良
王德辉
杜惠群
崔颖
施鑫
周幸
CHANG Menghan;ZHANG Junliang;WANG Dehui;DU Huiqun;CUI Ying;SHI Xin;ZHOU Xing(Department of Orthopaedics,General Hospital of the Eastern Theater Command of the Chinese People's Liberation Army,Nanjing 210002,China)
出处
《中华骨与关节外科杂志》
北大核心
2025年第6期511-515,共5页
Chinese Journal of Bone and Joint Surgery
基金
江苏省卫健委重点项目(K2024056)。
关键词
陈旧性下尺桡关节脱位
骨折手法复位
带袢钛板
Chronic Distal Radioulnar Dislocation
Manual Reduction of Fracture
Adjustable Loop Titanium Plate
