关节镜下“一针一线”缝合法治疗PalmerⅠB型TFCC浅层损伤的疗效观察

Efficacy of arthroscopic“one needle and one thread”suture method in the treatment of PalmerⅠB TFCC superficial injury

目的探讨腕关节镜下“一针一线”缝合法治疗PalmerⅠB型三角纤维软骨复合体(TFCC)浅层损伤的近期临床疗效。方法回顾性分析2017年8月至2021年6月该院收治的113例PalmerⅠB型TFCC损伤患者为研究对象,根据腕关节镜下修复术缝合方法分为对照组(54例)和观察组(59例),对照组采用由外向内缝合法,观察组采用“一针一线”缝合法。比较两组术前、术后6个月疼痛视觉模拟评分(VAS)和改良Mayo腕关节功能评分,评价两组线结反应发生率及腕关节活动度。结果两组术后6个月VAS低于术前,改良Mayo评分高于术前,差异有统计学意义(P<0.05);两组间VAS、改良Mayo评分比较,差异无统计学意义(P>0.05)。观察组线结反应发生率低于对照组(1.69%vs.14.81%),差异有统计学意义(P<0.05)。观察组无局部红肿刺痛,术后两组腕关节活动均良好。结论“一针一线”缝合法可有效治疗PalmerⅠB型TFCC浅层损伤,且可以有效避免线结反应的发生。

Objective To investigate the short-term clinical effect of“one needle and one thread”suture method under wrist arthroscopy in the treatment of Palmer type IB TFCC superficial injury.Methods A retrospective analysis of 113 Palmer typeⅠB triangular fibrocartilage complex(TFCC)injury patients admitted to this hospital from August 2017 to June 2021 were randomly divided into two groups.The control group was sutured from the outside to the inside,with a total of 54 cases;the experimental group was sutured with“one needle and one thread”,with a total of 59 cases.Visual analogue scale(VAS)scores and modified Mayo wrist function scores were compared between the two groups before and six months after the operation,and the incidence of linear knot reaction and range of motion of wrist were evaluated.Results VAS at 6 months after surgery was lower than that before surgery,and modified Mayo score was higher than that before surgery,with statistically significant differences(P<0.05).There was no significant difference in VAS and modified Mayo score between the two groups(P>0.05).The incidence of linear knot reaction in the experimental group was lower than that in the control group(1.69%vs.14.81%),with a statistically significant difference(P<0.05).There was no local redness,swelling or stinging pain in the observation group,and both groups had good wrist movement after surgery.Conclusion“One needle and one thread”suture method is effective in treating superficial Palmer typeⅠB TFCC injuries and can effectively avoid the occurrence of knot reaction.