月骨切除舟头融合微型钛板内固定治疗ⅢB期Kienbock病

Application of lunate resection,scaphoid fusion and internal fixation with mini titanium plate for the treatment of stage ⅢB Kienbock disease

目的探讨应用月骨切除舟头融合微型钛板内固定治疗IDB期Kienbock病的临床疗效。方法自2014年6月至2019年8月,我科应用月骨切除舟头融合微型钛板内固定术治疗Kienbock病患者9例,按照Lichtman分期标准均为ⅢB期,年龄37~49岁,平均41岁。所有病例均无明显腕部外伤史。根据疼痛、活动度、握力及功能情况应用腕关节Mayo评分评价手术疗效。结果术后切口均1期愈合,均无骨不连、伤口感染、皮肤坏死等并发症出现,,术后平均随访19个月,所有患者舟头融合体骨性愈合,平均愈合时间8.4周,腕部疼痛明显缓解,握力显著增高。按Mayo腕关节评分:良6例,可3例,平均76.1分结论应用月骨切除舟头融合微塑钛板内固定治疗ⅢB期Kienbock病,融合率高,明显缓解疼痛,改善腕关节功能.

Objective To investigate the clinical efficacy of lunate resection,scaphoid fusion and internal fixation with mini titanium plate for the treatment of stageⅢB Kienbock disease.Methods From June 2014 to August 2019,9 patients with Kienbock disease were treated with lunate resection,scaphoid fusion and internal fixation with mini titanium plate.According to Lichtman staging standard,all patients were in stageⅢB,with an average age of 41 years(range,37 to 49 years).All the cases had no obvious history of wrist trauma.According to the pain,range of motion,grip strength and function,the wrist Mayo score was used to evaluate the surgical efficacy.Results All the incisions achieved primary healing after operation.There were no bone nonunion,wound infection,skin necrosis and other complications.All the patients were follow-up for an average of 19 months.The bony union of scaphocapitate arthrodesis was found in all patients,and the average healing time was 8.4 weeks.The wrist pain was relieved and grip strength was significantly increased.According to Mayo wrist score,the results was rated as good in 6 cases,fair in 3 cases,with an average of 76.1 points.Conclusion The treatment of stageⅢB Kienbock disease with lunate resection,scaphoid fusion and internal fixation with mini titanium plate can significantly relieve pain and improve wrist joint function.