手部人工关节置换术的方法及注意事项.pdfVIP

中华手外科杂志2OO7年l2月第23卷第6期 Chin J Hand Sum，Deoernber2OO7，Vol 23，No．6 · 327 · · 骨 关 节 疾 病 · 手部人工关节置换术的方法及注意事项 李庆泰 王海华 童德迪 刘沐青 诸寅 薛云浩 【摘要】 目的 通过应用手部人工关节置换术，总结手术的方法及注意事项。方法 对14例 21指关节损伤的患者。应用人工关节进行置换，其中掌指关节10指，近侧指问关节 l1指。并对术中 出现的问题如指伸肌腱止点的保留、关节切除等作了详细的说明。结果 术后所有患者无一例发 生伤口感染，均达到I期愈合。随访时间为3个月～3．7年，平均1．6年。掌指关节活动度平均为 61．3o，近侧指问关节活动度平均为40．3o。大部分患者对手功能满意。结论 人工关节置换术是解 决手部关节僵直的好方法，但要注意手术适应证的选择。 【关键词】人工关节；指损伤； 外科手术；置换 Pearls and#fans in arthro#asty ofthe hand 13 Qing-tai，WANG Hai-hua，TONG De-di，删 Mu-qing， ZHU Hn，XUE Yun-hao．Depo,rtmertt ofHand Surgery，JishuitanHospital，Peking Unitersity，＆ 100035， China 【Abstract】Objective To sunmmrize the peadS and pitfalls of arthroplasty of the hand． Methods Twenty-one ioints in 14 patients were treated with ioint replacement arthroplasty．There were 10 metacarpophalangealjoints and l1 proximal interphalangealjoints．Details such as preservation of central slip of the extensor apparatus and resection of the daInaged joint were diseussed．Results There was no postoperative infecti0n．Primary would healing was achieved in all cases．Postoperat／ve follow up interval ranged fiom 3 months to 3．7 years with an average of 1．6 years．Range of motion of the metacarpophalangeal joint was 61．3o on average and that of the proximal interphalangeal joint 40．3。．Majority of the patients were satisfied wi山the results．Conclusion Joint replacement arthroplasty is a feasible way to treat joint stiffness of the hand as long as attention is paid to the proper surgical indications． 【Key words】Joint prosthesis； Finger injuries； Surgical procedures，operative； Replacement 各种原因造成的手部关节僵直都会对手的功能 造成掌指关节过伸畸形，掌板紧缩手术失败；其余9 产生严重影响，如创伤性关节炎、类风湿性关节炎及 指均为创伤后造成创伤性关节炎，关节僵直。近侧 关节内感染等，尤其是多个手指的关节或掌指关节 指间关节僵直11指，其中2指为类风湿性关节炎造 的僵直更是影响到人们日常的生活和工作…。因