腕关节镜辅助下重建陈旧性桡尺远侧韧带

Wrist arthroscopy assisted reconstruction of old distal radionlnar ligament injury

目的探讨腕关节镜辅助下重建陈旧性桡尺远侧韧带的方法。方法对14例陈旧性桡尺远侧韧带损伤者，在腕关节镜辅助下，重建桡尺远侧韧带（取掌长肌肌腱作移植肌腱）。结果术后14例均获得5～16个月的随访，术后与术前比较腕关节稳定性、活动幅度均有明显提高，疼痛无力症状明显缓解。按照改良Mayo腕功能评分标准评定：优9例，良4例，可1例。结论腕关节镜辅助下重建陈旧性桡尺远侧韧带，虽然对手术器械及技术要求较高，但该术式重建的桡尺远侧韧带更加接近生理解剖结构，手术创伤小，功能恢复满意。

Objective To discuss the technique of repairing old distal radioulnar ligament injury under wrist arthroseopy. Methods Fourteen eases of old distal radioulnar ligament injuries were treated under wrist arthroseopy to reconstruct the ligament with palmaris longus tendon graft. Results All 14 eases were follow-up for 5 to 16 months postoperatively. Comparing to preoperative evaluations, wrist stability and range of motion were significantly better. Pain and weakness were greatly improved. According to modified Mayo wrist scoring system the results were excellent in 9 eases, good in 4 cases and fair in 1 ease. Conclusion Wrist arthroseopieally assisted reconstruefion of distal radioulnar ligament, despite the demand for surgical instruments and techniques, restores the ligament closer to its physiological anatomy and leads to satisfactory functional recovery.