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目的:探讨关节镜辅助下腕部舟骨-大小多角骨关节(scapho-trapezio-trapezoeid，STT)融合术治疗晚期月骨缺血性坏死的临床疗效。方法:自2013年2月至2016年3月我们对11例Lichtman Ⅲb期月骨缺血性坏死患者，采用关节镜辅助下STT融合术治疗。所有患者术前、术后均测定腕关节运动范围和握力，并进行腕关节PRWE和改良Mayo腕关节评分。根据术前及术后腕部X线片情况进行疗效评估。结果:术后11例患者均获得随访，时间为13～91个月，平均40.8个月。术前VAS疼痛评分平均(6.45±0.58)分，术后(1.90±0.37)分，比较差异有统计学意义(n P<0.05)，术后腕关节疼痛均得到缓解。术前患侧握力平均为(8.53±1.83) kg，术后(14.48±2.38) kg；腕关节PRWE评分术前为74.86±2.13，术后21.46±4.57；改良Mayo腕关节评分术前为31.36±2.53，术后70.91±3.22，差异均有统计学意义(n P<0.05)，术后腕关节握力及功能评分均明显改善。远期X线片结果表明患者月骨塌陷于术后无明显加剧。n 结论:关节镜辅助下的STT融合术治疗Lichtman Ⅲb期月骨缺血性坏死，可以良好地缓解疼痛，改善腕关节功能，防止月骨继续塌陷、疾病进展，而对于腕关节主动活动度无明显改善。“,”Objective:To investigate the clinical efficacy of arthroscopic-assisted scapho-trapezio-trapezoeid (STT) arthrodesis for the treatment of the Lichtman Ⅲb stage Kienb?ck disease.Methods:From February 2013 to March 2016, 11 patients diagnosed as Lichtman Ⅲb stage Kienb?ck disease were treated by arthroscopic-assisted STT arthrodesis. The range of motion and grip strength of the wrist were measured before and after the operation, and the wrist PRWE and the modified Mayo wrist score were performed. The curative effect was evaluated according to the X-ray examination results before and after operation.Results:All the 11 patients were follow-up for 13 to 91 months, with an average of 40.8 months. The average score of VAS was (6.45±0.58) before operation and (1.90±0.37) after operation. The difference was statistically significant (n P<0.05). The wrist pain was relieved after operation. The average grip strength before operation was (8.53±1.83) kg, and after operation was (14.48±2.38) kg; the wrist PRWE score before operation was 74.86±2.13, and after operation was 21.46±4.57; the modified Mayo wrist score before operation was 31.36±2.53, and after operation was 70.91±3.22. The differences were statistically significant (n P<0.05), and the wrist grip strength and function score after operation were significantly improved. The results of long-term X-ray showed that there was no obvious aggravation after the operation.n Conclusion:The application of arthroscopic-assisted STT arthrodesis for the treatment of Lichtman Ⅲb stage Kienb?ck disease can relieve the pain, improve the function of wrist joint, prevent the collapse of the lunate and the progression of the disease, but not improve the active motion of wrist joint.