腕塌陷的诊断和治疗进展

Advances concerning the diagnosis and treatment of carpal collapse

最近20年对腕塌陷有系统研究,X线片诊断标准的提出和修正进一步明确了腕塌陷的概念,舟月进行性腕塌陷分期法帮助临床医生更客观地追踪该病的发展和愈后。相关生物力学的研究使对此症病理机制的认识大为加深,并且成为手术方法选择的重要参考依据。以四角融合术为代表的各种部分腕骨融合术和近排腕骨切除术可以有效缓解症状,阻止腕塌陷的继续,成为该病的主要治疗手段,但必须要根据桡腕关节和腕中关节的具体情况灵活使用。硅胶假体置换术由于其明显的并发症基本被淘汰。

This paper reviews the advances concerning the diagnosis and treatment of carpal collapse. Systematic study on carpal collapse was launched only two decades ago. The improved roentgenologic diagnosis has deepened our understanding of the disorder. Its classification has helped doctors conduct objective follow ups of the progress and prognosis of the disease. And the related biomechanical research has made clear mechanism of the collapse which can serve as an important basis for choice of operative methods. The various partial carpal arthrodesis, of which the commonest is four corner arthrodesis, and proximal row carpectomy are proved to be effective in relieving most symptoms and ending the continuation of collapse, so they have become major treatment methods for the disease. But operative methods have to be chosen in the light of detailed conditions of radiocarpal and midcarpal joints. The silicon arthroplasty has been abandoned due to its serious complications.