求教:手腕三角纤维软骨撕裂伤不能治疗吗?

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MRI结果: 两只手腕好像都有三角纤维软骨撕裂伤,至少右手明显有三角纤维软骨撕裂伤。 有没有办法治疗?只能做手术吗?详细病情见下面。谢谢。

右手腕: TFC退化,其径向变薄50%,从近端表面到远极面从竞相到侧边可见倾斜裂痕。尺骨连接基本未受损。DRUJ内有轻度液体增加。DURJ store仍然合适。有明显茎突前凹陷。尺侧副韧带基本未受损。尺侧伸腕肌腱未受损。

桡舟月韧带及月三角背侧韧带基本未受损。

横向屈肌和伸肌肌腱基本完好。腕道未见异常。

腕部构造(对准)正常。三角骨内可见中度狭窄水肿。沿三角骨近端表面的软骨似有变薄迹象。虽然TFC未彻底损伤,尺骨变薄损伤的TFC有瞬间撞伤,从而对近端三角骨施加压力。

桡腕关节有轻度渗出液。

印象:
1。 退化的TFC有中度变薄和有层理的撕裂。基本没有收缩。
2。 近端三角骨中的水肿可能反映为瞬间撞击。
3。 轻度桡腕关节和DYRJ渗出液。


左手腕: TFC退化。TFC的尺骨连接基本未受损,但表面不规则且有轻度裂缝。没有完全穿透(大概是指裂缝没有完全穿透?)。 远端桡尺关节(DRUJ)基本未脱位。DRUJ内有轻度液体增加。

桡舟月韧带及月三角背侧韧带基本未受损。腕部构造(对准)正常。看不到骨折。桡腕关节有轻度渗出液。横向屈肌和伸肌肌腱基本完好。看不到狭窄水肿。桡侧屈腕肌腱鞘内可见少量液体。肌腱本身看似正常。横向屈肌和伸肌肌腱其他部分未见异常。正中神经和神经血管束在正常范围内。三角骨凹陷内有轻度增加液体。三角骨内可见少量骨内腱鞘囊肿。

印象:
TFC轻度退化。没有明确的完全穿透。有腱鞘炎,桡侧屈腕肌腱鞘内可见少量液体。


以上为自己的翻译,可能会有错。诊断原文如下:
MRI RIGHT WRIST: The TFC is degenerate, It is moderately thinned by 50% in its radial half. There is oblique tearing seen extending from the proximal surface to the distal surface, from radial side to lateral side. The ulnar attachments are still grossly intact. Mild increase fluid in the DRUJ. The DRUJ store remains congruent. Pre-styloid recesses are clear. The ulnar collateral ligament is grossly intact. The extensor carpi ulnaris tendon is intact.

Scapholunate and lunotriquetral ligaments are grossly intact.
The traversing flexor and extensor tendons are grossly preserved. Carpal tunnel is unremarkable.

Carpal alignment is normal. Focal area of moderate narrow edema is seen within the triquetral bone. There appears to be mild thinning of the cartilage along the proximal surface of the triquetrum. Although the TFC is not completely torn, there may be transient impaction of the ulna across the thin and torn TFC, such that it may be exerting pressure on the proximal triquetrum.

Mild effusion of the radiocarpal joint.

Impression:
1. Degenerate TFC with moderate thinning and superimposed tearing as described. No gross retraction.
2. Edema in the proximal triquetrum may reflect underlying transient impaction.
3. Mild radiocarpal and DRUJ effusions.
MRI LEFT WRIST: The TFC is degenerate, Ulnar attachment of the TFC is grossly intact. There is mild fissuring and surface irregularity. No full thickness perforation. The DRUJ aligament is within normal limits. Mild increase fluid in the DRUJ.

The scapholunate and lunotriquetral ligaments are grossly intact. There is normal carpal aligament. No fractures are seen. There is mild radiocarpal joint effusion. The traversing flexor and extensor tendons are preserved. There is no evidence of narrow edema. Small amount of fluid seen within the flexor carpi radialis tendon sheath. The tendon itself appears intact. The remainder of the traversing flexor and extensor tendons are unremarkable, The median nerve and ulnar neurovascular bundle are within normal limits. Mild increased fluid seen within the pisotriquetral recess. A small intraosseous ganglion cyst seen within the triquetrum.

Impression:

Mildly degenerate TFC. No definite full-thickness perforation, Small amount of fluid within the Flexor carpi radialis tendon sheath in keeping with tenosynovitis.
 
手腕三角纤维软骨撕裂伤

根据你提供的资料,保守治疗和抗炎治疗都不能解决问题,只能手术. 你的软骨没有较严重损伤,也没有骨折, 应该属于较轻微的损伤.
 
以你的情形根本不须手术治疗。若需帮助请联系:613-292-2398.
 
根据你提供的资料,保守治疗和抗炎治疗都不能解决问题,只能手术. 你的软骨没有较严重损伤,也没有骨折, 应该属于较轻微的损伤.

医生说右手需要手术,似乎左手不需要。去看Physiotherapist,她说不知道怎样才能把左腕的fluid排出。我问那为什么还要作理疗,她说增加mobility。可她测试结果是mobility没问题。也不知道physiotherapy 究竟有没有用。
 
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