医学
手腕
纤维软骨
手腕痛
眼泪
关节镜检查
腕关节镜检查
韧带
桡尺远侧关节
外科
骨关节炎
病理
替代医学
关节软骨
出处
期刊:Journal of the American Academy of Orthopaedic Surgeons
[American Academy of Orthopaedic Surgeons]
日期:2008-06-01
卷期号:16 (6): 320-329
被引量:50
标识
DOI:10.5435/00124635-200806000-00004
摘要
Acute trauma to the triangular fibrocartilage complex includes tears of the fibrocartilage articular disk substance and meniscal homolog as well as radioulnar ligament avulsions, with or without an associated fracture. Patient evaluation includes clinical examination, imaging studies, and wrist arthroscopy (diagnostic). The Palmer classification is typically used to define injuries to the triangular fibrocartilage complex. The critical distinction is in differentiating injuries that produce instability of the distal radioulnar joint from those that do not. Also important is the recognition of acute injuries in the context of an ongoing degenerative pattern (ie, Palmer class 2 lesions). Nonsurgical management includes temporary splint immobilization of the wrist and forearm, oral nonsteroidal anti-inflammatory medication, corticosteroid joint injection, and physical therapy. Surgical strategies include débridement, acute repair, and subacute repair. Most surgical procedures can be performed arthroscopically. However, open ligament repair may be needed in the setting of distal radioulnar joint instability.
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