腕关节部分融合治疗退行性腕关节炎的疗效

Results of limited wrist arthrodesis

目的评价头骨、月骨、三角骨及钩骨四关节融合治疗退行性腕关节炎的效果。方法1997年7月～2002年12月应用腕关节部分融合术创伤性腕关节炎治疗20例,术后随访15个月,随访检查包括术后腕关节疼痛程度、腕关节活动度、握力以及患侧X线检查。视觉模拟评分法评价疼痛程度。腕关节总体功能评价采用Krimmer腕关节评分表。结果腕疼痛值静息时为2.1,用力后为5.3;屈伸活动度为64°(对侧126°);尺桡偏为30°(对侧57°);平均握力为24kg(对侧40kg)。Krimmer腕关节评分值为67。X线检查头、月、三角及钩骨均融合。结论腕关节部分融合后能保存腕关节部分功能,是治疗退行性腕关节炎有效的方法。

Objective To evaluate the results of limited wrist arthrodesis. Methods From July 1997 to December 2002, 20 patients with degenerative arthritis were treated with four-comer arthrodesis （lunate, capitate, hamate, triquetrum） . The mean follow-up time was 15 months after surgery. The examination included subjective pain, range of movement of the wrist and grip strength. Radiographs were performed in all patients. The results were evaluated according to the Krimmer wrist scores. Results Mean pain scores were 2.1 （non-stress） and 5.3 （stress）. The average grip strength was 24 kg, compared with 40 kg for the other hand. Wrist range of motion （extension/flexion） averaged 64°, compared with 126°or the opposite wrist. Radial/ulnar deviation was 30° （57° for the contralateral side）. All arthrodeses united. The mean vale of Krimmer wrist score was 67. Conclusion Limited wrist arthrodesis is an effective method to treat degenerative arthritis.