腕关节镜辅助下修复舟月韧带治疗腕关节不稳定

目的分析腕关节镜辅助下利用骨锚修复腕舟月韧带的疗效。方法自2008年10月一2011年4月，对6例腕关节损伤患者通过腕关节镜探查舟月韧带，确定损伤部位后，应用Mitek骨锚重建舟月韧带，术后石膏托固定腕关节于功能位4周后开始患腕被动活动，6周后开始主动运动。术后随访6个月，测定患腕术前及术后的握力、应用改良Mayor评分法对腕关节功能进行客观评分、患者源性调查表（disabilityofarm-shoulder-hand，DASH）问卷法进行主观评分，以及术前与术后的x片检查对比。并与健侧腕关节x片进行对比。结果术后6例患者腕关节疼痛均有缓解．握力明显改善。按照改良Mayor评分：优2例，良3例，可1例，优良率为83．3％，与术前评分的差异有统计学意义（P〈O．01）。术后DASH分值平均为（14．6±7．0），与术前评分差异有统计学意义（P〈O．01）。结论舟月韧带损伤是导致腕关节不稳定的重要原因之一，在腕关节镜辅助下利用骨锚修复舟月韧带是一种微创、实用的方法。

Treatment of carpal instability by repairing scapholunate interosseous ligament assisted with wrist arthoroscopy

Objective To analysis the effects for repairing the scapholunate interosseous ligament with bone anchor assisted with wrist arthroscopy. Methods From October 2008 to April 2011, 6 cases of wrists injury were determined the site of scapholunate interosseous ligament injury by wrist arthroscopy, and then to restructed the ligament with Mitek bone anchor. The wrists were immobilized in functional position by plaster for 4 weeks postoperation, suffering from wrists passive activities 4 weeks and active movement 6 weeks postoperation; The patients were followed up for 6 months, it were analyzed with grip strength, improved wrist functional Mayor score, patient-derived questionnaire （DASH） in preoperation and postoperation, and the preoperative and postoperative X-ray examination were compared with the contralated wrist X-ray. Results The wrist pain were relieved and grips trength were improved significantly 6 weeks postoperation, It were excellent in 2 cases, good in 3 cases, and the good rate was 83.3% accord to Mayor score, it were significantly （P〈O.01） The average DASH scores （14.6 ±7.0） postoperation were signifi compared with preoperative scores; cantly （P 〈0.01） compared with preoperative scores. Conclusion Scapholunate interosseous ligament injury is an important reason for leading to wrist instability. It is an minimally invasive, practical method to repair the ligament with bone anchor assisted wrist arthroscopy.