手部小关节置换的现状与进展

Current status and progress of arthroplasty in hand surgery

严重的关节退变、炎性反应或者由创伤导致的关节表面及形态结构的破坏,都符合人工小关节置换的手术指征。类风湿性关节炎(RA)所造成的手部关节破坏是目前人工小关节置换最主要的治疗对象。经过半个世纪的探索,以Swanson硅胶假体为代表的手部人工小关节置换在重塑关节生理形态,恢复关节的功能与力量方面带来了良好的疗效。但就目前的发展现状与假体置换的远期随访来说,手部小关节置换尚未达到像负重大关节那样的理想效果。因此,手部小关节假体的设计理念与临床实践始终处于探索阶段。

Severely degenerated joint,inflammatory reaction and posttraumatic destruction of articular surface are in accord with arthroplasty operation indications. The severe destruction of hand joint caused by rheumatoid arthritis is the main target group for arthroplasty surgery. Based on an exploration of half century,Swanson＇s artificial silicone prosthesis has a good curative effect in the reconstruction of physiology,function and strength. Arthroplasty in hand surgery still can not obtain a good result like the weight-bearing joints such as knee and hip,according to the current status and long term follow-up.Therefore,this field is still in the exploration stage because of insufficient clinical experiences and the immature concept of design for prosthesis in hand surgery.