大多角骨切除第一腕掌关节成形联合韧带重建肌腱填塞术治疗第一腕掌关节骨关节炎的疗效观察

Observation on the therapeutic effect of mostly angular bone resection,first carpometacarpal joint arthroplasty combined with ligament reconstruction and tendon tamponade in the treatment of first carpometacarpal joint osteoarthritis

目的评估第一腕掌关节骨性关节炎手术治疗的有效性的有效性。方法2019年6月~2022年6月对15例第一腕掌关节骨性关节炎病人行大多角骨切除第一腕掌关节成形联合韧带重建肌腱填塞术,通过X线、拇指关节活动度、握力、捏力及疼痛分级(VAS)评价手术疗效。结果术后9个月随访显示,病人疼痛减轻,拇指活动度、握力和捏力增强,综合手术优良率达86.7%。结论大多角骨切除第一腕掌关节成形联合韧带重建肌腱填塞术对可缓解疼痛、改善活动度及增强手部力量,方法简单有效,疗效显著。

Objective To evaluate the effectiveness of treatment for osteoarthritis of the first carpometacarpal joint.Methods From June 2019 to June 2022,15 patients with osteoarthritis of the first carpometacarpal joint underwent a combined procedure of trapezium excision,first carpometacarpal joint arthroplasty,ligament reconstruction,and tendon interposition.Surgical efficacy was assessed using X-rays,thumb joint range of motion,grip strength,pinch strength,and pain rating(VAS).Results 9 months postoperative follow-up revealed significant pain reduction,increased thumb range of motion,enhanced grip and pinch strength,with an overall surgical excellence rate of 86.7%.Conclusion Trapeziecotomy arthroplasty with ligament reconstruction and tendon tamponade demonstrates significant efficacy in treating osteoarthritis of the first carpometacarpal joint,effectively alleviating pain,improving thumb mobility,and enhancing hand strength.The method is simple and effective.