手腕部位微創手術

Minimally Invasive Surgery in Hand and Wrist

張志豪(Chih-Hao Chang)

《台灣醫學》 19卷1期 (2015/01) Pp. 45-48

https://doi.org/10.6320/FJM.2015.19(1).07

摘要

微創手術的發展是外科近20年來的主要課題。達到最小傷口、手術路徑最小組織創傷，進而早日康復，是微創手術能帶給人類疾病治療的最大貢獻。手腕部的微創手術，在近20年也有極大的發展，而這些進展主要是因為關節鏡手術器械與植入物醫材的進步，包括新式壓迫型螺絲釘，微創型互鎖式鋼板與注射型人工骨的新發明。手腕部的微創手術主要分為兩個領域。第一大類為使用關節鏡，使用關節鏡可以直接看到關節內部構造，主要的適應症為三角韌帶軟骨病灶，舟月韌帶斷裂，遠端橈骨關節內骨折復位，腱鞘囊腫切除，局部腕骨融合術，及小關節發炎組織清除及關節囊整型術等。第二大類為經皮微創手術，主要是藉由Ｘ光機的定位與導航，主要的適應症為無頭式壓迫鋼釘植入，微創互鎖式鋼釘鋼板植入，可注射型人工骨植入等。目前部位與適應症包括可以做腕關節、基底關節、指掌關節、近端指關節等部位之關節鏡，及所有手腕部骨折的經皮微創手術。

關鍵字

微創手術 ； 手 ； 腕

並列摘要

Minimal invasive surgery is one of greatest advancements in surgery in recent two decades. Minimal invasive surgery is not only the small wound but also least tissue damage. In the field of hand and wrist, minimal invasive surgery makes great improvements in many aspects. These improvements are dependent on the progress of arthroscopy instrument and new implants. There are two major categories in minimal invasive surgery in hand and wrist. The first is arthroscopy. Through the arthroscopy, the hand surgeon can visualize internal structures in the small joints including wrist joint, thumb basilar joint, metacarpophalangeal joint, and proximal interphalangeal joint. Through the arthroscopy, we can treat these diseases including TFCC lesion, scapholunate dissociation and reconstruction, intercarpal instability, ligament interposition procedure in the wrist, DRUJ ligament reconstruction, wafer procedure of DRUJ portion, reduction intra-articular displacement of distal radius fracture, synovitis, joint mice removal, ganglion excision, thermal coagulation, joint capsule release and tightening, and regional fusion of carpal bones etc. The second is percutaneous fixation method. Through many new implants development and fluoroscope-guided, it makes this method more easily and confidently. These new implants include new cannulated screw, MIPPO interlocking plate and screws, and injectable artificial bone substitutes. Following the new technologies invent, the progresses of surgical methods and treatments develop very fast and amazing. We hoped to create more effective and least damage of surgical method for human welfare.

並列關鍵字

minimal invasive surgery ； hand ； wrist

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