| 腕关节镜下高位单骨道修复青少年男性Palmer ⅠB型三角纤维软骨复合体损伤 |
| Arthroscopic high single-tunnel repair for Palmer type ⅠB triangular fibrocartilage complex injuries in adolescent males |
| 投稿时间：2024-11-29 |
| DOI：10.3969/j.issn.1672-5972.2025.06.007 |
| 中文关键词: 三角纤维软骨复合体 腕关节镜 高位单骨道 青少年 |
| 英文关键词:Triangular fibrocartilage complex Wrist arthroscopy High single-bone tunnel Adolescent |
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| 中文摘要: |
| 目的 探究腕关节镜下高位单骨道修复青少年男性Palmer ⅠB型三角纤维软骨复合体（triangular fibrocartilage complex, TFCC）损伤的手术技术及初步临床结果。方法 分析2020年6月至2023年6月湖北理工学院附属黄石爱康医院骨科19例关节镜下高位单骨道修复Palmer ⅠB型TFCC损伤的青少年男性患者资料。年龄（16.9±2.7）岁（14～20岁）；受伤至手术时间（9.7±3.1）个月（6～12个月）。所有纳入病例排除其他骨性病变，术中镜下证实Palmer ⅠB型损伤，采用高位单骨道技术修复。记录分析纳入病例的手术时间、伤口愈合情况、相关并发症发生情况，以及术后VAS评分、Mayo评分、无痛掌屈-背伸ROM、旋前-旋后ROM。结果 所有纳入病例均顺利完成手术，随访8～12个月，平均（10.7±2.9）个月。患者术前的VAS评分为（3.7±1.4）分，高于术后3个月和术后6个月的VAS评分［分别为（1.2±1.1）分和（1.1±1.0）分］，术前术后比较差异具有统计学意义（P＜0.05）；患者术前Mayo评分（88.2±7.2）分，低于术后3个月和6个月的Mayo评分［分别为（91.8±4.1）分和（94.7±3.6）分］，术前术后比较差异具有统计学意义（P＜0.05）；无痛掌屈-背伸ROM术前及术后3、6个月比较，差异均无统计学意义（P＞0.05）；无痛旋前-旋后ROM术前（124.6±10.1）°，低于术后3个月及术后6个月的无痛旋前-旋后ROM［分别为（148.4±15.7）°、（170.2±9.6）°］，术前术后差异具有统计学意义（P＜0.05）。结论 腕关节镜下高位单骨道修复青少年男性Palmer ⅠB型TFCC损伤可有效缓解患者的关节疼痛，恢复关节稳定性，具有良好的安全性和可操作性，值得临床中进一步推广及研究。 |
| 英文摘要: |
| Objective To investigate the surgical technique and preliminary clinical outcomes of arthroscopic high single-tunnel repair for Palmer type ⅠB triangular fibrocartilage complex (TFCC) injuries in adolescent male.Methods Clinical data from 19 adolescent male patients [aged (16.9±2.7) years, range: 14-20 years] with arthroscopically confirmed Palmer type ⅠB TFCC injuries treated with high single-tunnel repair in Huangshi Love and Health Hospital Affiliated to Hubei Polytechnic University from June 2020 to June 2023 were analyzed. The time from injury to surgery was (9.7±3.1) months (range: 6-12 months). All included cases excluded other bony pathologies and underwent arthroscopic high single-tunnel repair. The following were recorded: Surgical duration, healing status, complications, postoperative joint mobility, visual analogue scale (VAS) scores, and Mayo wrist scores.Results All patients completed follow-up for 8-12 months, with a mean of (10.7±2.9) months. Surgery was successful in all cases. Preoperative VAS was (3.7±1.4) scores, decreasing to (1.2±1.1) scores at 3 months and (1.1±1.0) scores at 6 months postoperatively, with statistically significant differences before and after operation (P<0.05). The Mayo score improved from (88.2±7.2) preoperatively to (91.8±4.1) at 3 months and (94.7±3.6) at 6 months postoperatively (P<0.05). There was no significant improvement in pain-free wrist flexion-extension range of motion (ROM) pre- vs. postoperatively (P>0.05). Pain-free pronation-supination ROM increased from (124.6±10.1)° preoperatively to (148.4±15.7)° at 3 months and (170.2±9.6)° at 6 months postoperatively (P<0.05), with significant improvement between 3 and 6 months (P<0.05).Conclusion Arthroscopic high single-tunnel repair for Palmer type ⅠB TFCC injuries in adolescent males is an effective treatment for alleviating joint pain and restoring stability. It is also a safe and feasible procedure, warranting further clinical application and research. |
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