腕关节镜掌侧入路的临床应用

目的：介绍掌侧入路在腕关节镜中的应用，并对IB、ID型的TFCC及桡腕背侧韧带损伤的关节镜下手术治疗疗效进行评价。方法：2005～2008年我们通过腕关节镜掌侧入路，关节镜下应用inside-out缝合技术共治疗腕关节IB型、ID型的TFCC损伤患者13例，桡腕背侧韧带损伤患者2例，术后平均随访20个月，采用Green-O’Brien功能评定方法对腕关节功能进行评估。结果：14例患者腕关节疼痛消失，1例偶有轻度疼痛，无需使用止痛药物；关节功能评定优13例，良1例，一般1例，优良率93.3%。结论：关节镜下治疗TFCC损伤具有良好疗效，在观察和处理腕背侧结构时，掌侧入路在手术技术上具有操作简单、快速安全的优点。

Clinical application of wrist arthroscopy through volar approach

Objective：To describe clinical application of wrist arthroscopy through volar approach, and evaluate its therapeutic effects on IB, ID TFCC and dorsal radiocarpal ligament(DRCL) tear．Methods： From 2005 to 2008，13 patients suffered from IB, ID TFCC or DRCL tear were treated with arthroscopic surgery through volar approach, and assessed by the Green and O'Brien wrist scoring system．The follow-up period was about 20 months averagely. Results: Pain disappeared nearly for all patients, except for one case with mild pain occasionally． According to the Green and O'Brien wrist scoring system, 11 of 13 patients were excellent, 1 good and 1fair．Conclusions： Arthroscopic surgery through volar approach is reliable for treating dorsal wrist structures, reaching operating field quickly and safely during the operational process of IB, ID TFCC or DRCL tears.