论文部分内容阅读
目的 探讨腕关节镜下滑膜切除术治疗慢性腕关节炎的方法及疗效.方法 2011年11月至2014年3月采用腕关节镜下滑膜切除术治疗慢性腕关节炎33例,术前术后采用改良Mayo腕关节评分及DASH量表评价腕关节镜下滑膜切除术治疗慢性腕关节炎的疗效.结果 术后所有患者均获得随访,随访时间为7～26个月(平均19.7个月).术前患侧握力平均为健侧的59.6％(43.2％ ～ 68.4％),术后平均为78.2％(66.2％ ～ 89.7％).腕关节屈伸范围术前为(76.0±16.0)°,术后为(116.0±18.0)°,尺桡偏术前为(22.0±11.0)°,术后为(42.0±14.0)°;腕关节旋前、旋后活动度术前为(128.0± 18.0)°,术后为(149.0±22.0)°.改良Mayo腕关节评分术前平均为46.7(33 ～ 69),术后平均为80.5(56～95).DASH量表评分术前平均为42.4(22～53),术后平均为18.2 (12～ 38).改良Mayo腕关节评分及DASH量表评分术后较术前均有明显改善(P＜0.05).结论 关节镜下滑膜切除术治疗慢性腕关节炎具有微创,术后恢复快,疗效较好等优点.“,”Objective To explore the application and efficacy of arthroscopic synovectomy in the treatment of chronic wrist arthritis.Methods Thirty-three patients with chronic wrist arthritis were treated with arthroscopic synovectomy.The modified Mayo Wrist Score and DSAH questionnaire were applied to evaluate the preoperative and postoperative function of the patients.Results All patients were follow-up for 7 to 26 months.The average follow-up time was 19.7 months.The preoperative grip strength was 59.6％ (range,43.2％ to 68.4％) of that of the contralateral side.Postoperatively grip strength increased to 78.2％ (range,66.2％ to 89.7％) of the normal side.Wrist flexion and extension range was (76.0 ± 16.0)° preoperatively and (116.0 ± 18.0)° postoperatively.Range of motion of ulnar and radial deviation was (22.0 ± 11.0)°preoperatively and (42.0 ± 14.0)° postoperatively.Forearm rotation was(128.0 ± 18.0)° preoperatively and (149.0± 22.0)° postoperatively.Preoperative Mayo wrist score was 46.7 on average (range,33 to 69),while postoperative Mayo wrist score was 80.5 on average (range,56 to 95).DASH score increased from 42.4 (range,22 to 53) preoperatively to 18.2 (range,12 to 38) postoperatively.According to the Wilcoxon signedrank test,there were significant statistical differences between the postoperative and preoperative modified Mayo Wrist scores and DASH questionnaire scores (P ＜ 0.05).Conclusion Arthroscopic synovectomy was an minimally invasive and effective method for the treatment of chronic wrist arthritis.