腕关节镜下经穿骨固定技术治疗TFCC损伤

Treatment of TFCC Injury by Percutaneous Fixation Under Wrist Arthroscopy

目的研究腕关节镜下经穿骨固定技术治疗(triangular fibrocartilage complex,TFCC)损伤(三角纤维软骨复合体损伤)的临床疗效。方法选取2018年4月-2020年9月本院收治的35例TFCC损伤(ⅠB型)患者作为研究对象,所有患者均接受腕关节镜下经穿骨固定技术治疗,分析该疗法的具体效果。结果35例患者均顺利完成关节镜下手术治疗,术后无感染、神经及肌腱损伤等并发症,切口愈合时间均为Ⅰ期;根据VAS疼痛评估标准以及腕关节功能Cooney评估标准,患者术前评分分别为(6.64±1.02)分、(53.72±10.38)分,术后分别为(4.39±0.76)分、(86.39±8.16)分,数据显示疼痛程度明显下降、腕关节功能明显恢复,差异均有统计学意义(P=0.000、0.000);统计腕关节功能恢复情况显示,优21例、良12例、可2例,差0例,优良率为94.29%。结论腕关节镜下经穿骨固定技术可用于TFCC损伤的临床治疗,其效果较为理想,可以明显改善患者腕关节功能,减少术后疼痛程度以及各种并发症,缩短康复时间,帮助患者尽快回归正常生活。

Objective To study the clinical effect of transosseous fixation under wrist arthroscopy in the treatment of triangular fibrocartilage complex(TFCC) injury(triangular fibrocartilage complex injury). Methods Thirtyfive patients with TFCC injury(type Ⅰ B) treated in our hospital from April 2018 to September 2020 were selected as subjects. All patients were treated with percutaneous bone fixation under wrist arthroscopy,and the specific effects of this therapy were analyzed. Results All the 35 patients completed arthroscopic surgery successfully. There were no postoperative complications such as infection, nerve and tendon injury, and the wound healing time was stage Ⅰ. According to VAS pain assessment criteria and wrist function Cooney evaluation criteria, the preoperative and postoperative scores were(6.64±1.02) points,(53.72±10.38) points,(4.39±0.76) points,(86.39±8.16) points respectively. The data showed that the pain degree decreased significantly and the wrist function recovered significantly, and the difference was statistically significant(P=0.000, 0.000).Statistics showed that the functional recovery of wrist joint was excellent in 21 cases, good in 12 cases, fair in 2 cases and poor in 0 case. the excellent and good rate was 94.29%. Conclusion The technique of transosseous fixation under wrist arthroscopy can be used in the clinical treatment of TFCC injury, and its effect is ideal. It can significantly improve the wrist function of patients, reduce the degree of postoperative pain and various complications, shorten the recovery time, and help patients return to normal life as soon as possible.