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- Ligament Reconstruction and Tendon Interpositional Arthroplasty for Degenerative Arthritis of the Thumb Trapeziometacarpal Joint
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題名 | Ligament Reconstruction and Tendon Interpositional Arthroplasty for Degenerative Arthritis of the Thumb Trapeziometacarpal Joint=韌帶重建及肌腱植入關節成形術在大多角骨及掌骨關節骨性關節炎的應用 |
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作者 | 劉毅; 張明超; | 書刊名 | 中華醫學雜誌 |
卷期 | 62:11 1999.11[民88.11] |
頁次 | 頁795-800 |
分類號 | 416.61 |
關鍵詞 | 韌帶重建; 骨性關節炎; 肌腱植入術; 大多角骨及掌骨關節; Ligament reconstruction; Osteoarthritis; Tendon interposition arthroplasty; Trapeziometacarpal joint; |
語文 | 英文(English) |
中文摘要 | 背景:拇指的腕掌關節是手部運動功能中最重要的關節,也容易發生骨性關節炎。然而,有關中國人與此疾病關係的文章至今仍很少。 方法:在過去11年中,我們治療42位大多角骨及掌骨關節骨性關節炎患者(47隻手),他們都是中國人。其中36位患者(36隻手)接受外科治療,手術方法為韌帶重建及肌腱植入術,並按照病情的輕重,決定手術時切除全部的大多角骨,還是僅切除部份的第一腕掌關節。術後追蹤平均106個月,包括臨床檢查及X-ray評估。 結果:第Ⅱ期的3位患者中,2位為[優],1位為[好];第Ⅲ期的18位患者中,14位為[優](77.8%),4位為[好](22.2%);第Ⅳ期的15位患者中,10位為[優](66.6%),4位為[好](26.7%)以及1位為「尚可」(6.7%)。整個研究沒有任何患者的結果為「壞」。 結論:韌帶重建及肌腱植入術是治療拇指基部大多角骨及掌骨關節退化性關節炎的一個良好方法。此外,僅切除部份大多角骨及掌骨關節適用於第Ⅱ期患者,而切除全部大多角骨則適用於第Ⅲ及第Ⅳ期患者。雖然得此疾病的女性比男性多,但男性因工作繁重,故尋求治療者較多。 |
英文摘要 | Background: The trapeziometacarpal joint provides important functions for the hand. This joint is often involved in primary osteoarthritis. Methods: From November 1982 to December 1995, we encountered 42 patients (47 hands) with osteoarthritis (OA). All the patients were Chinese. Thirty-six patients (36 hands) were treated surgically. Ligament reconstruction and tendon interposition arthroplasty were done with total removal of the trapezium or partial removal of trapeziometacarpal joint depending on the stage of the disease. These patients were monitored for an average of 106 months and evaluated both clinically and roentgenographically. Results: Of three stage Ⅱ cases, the results of two were excellent and one was good. Of the 18 stage Ⅲ patients, 14 had excellent (77.8%) and four had good (22.2%) results. In the 15 stage Ⅳ patients, 10 had excellent (66.6%), four had good (26.7%) and one had fair (6.7%) results. No patient had poor results. Conclusions: Ligament reconstruction and tendon interpositional arthroplasty is a good alternative in treating degenerative arthritis of the trapeziometacarpal joint of the thumb. Partial removal of the diseased joint is indicated for stage Ⅱ, and total removal of the trapezium is indicated for stage Ⅲ and Ⅳ patients. Men seek treatment more often than women due to their need to work, even though women are more commonly afflicted with this disorder. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。