摘要目的:探讨关节镜辅助大多角骨部分切除联合襻钢板悬吊治疗EatonⅡ、Ⅲ期第1腕掌关节炎的临床疗效。方法:回顾性收集2020年1月至2022年6月于深圳市第二人民医院诊治的EatonⅡ、Ⅲ期第1腕掌关节炎患者15例（16侧），男5例（双侧1例）、女10例，年龄为（56.7±6.4）岁（范围46~75岁）。术前X线片示关节间隙狭窄、周围骨赘形成，并向桡背侧脱位。行关节镜下部分大多角骨切除，采用高强线及指骨钢板自制襻钢板悬吊固定第1掌骨。记录重返工作时间，比较术前和末次随访时第1腕掌关节位置和掌骨下沉情况，疼痛视觉模拟评分（visual analogue scale，VAS）、拇指Kapandji评分、上肢功能评定表评分（disabilies of the arm, shoulder, and hand，DASH）及捏力、握力。结果:15例随访时间为（19.6±6.3）个月（范围11~36个月）。术后即刻X线片证实腕掌关节均得到复位，第1掌骨高度维持满意。患者术后恢复日常活动时间为（18.69±3.70）d，恢复正常工作时间为（24.63±4.91）d。VAS由术前（6.56±1.15）分降至末次随访1.00（0.75，1.25）分，Kapandji评分由（8.00±0.82）分提升至8.00（7.25，9.00）分，DASH评分由（24.06±3.19）分降至4.00（3.00，5.00）分，除Kapandji评分外的差异均有统计学意义（ Z=-4.905， P<0.001； Z=-0.121， P=0.905； Z=-4.846， P<0.001）。握力由术前16.4（14.13，18.68）kg提升至末次随访的（26.14±3.27）kg，捏力由（1.70±0.35）kg提升至（3.58±0.91）kg，差异有统计学意义（ Z=-4.617， P<0.001； t=-7.669， P<0.001）。 结论:关节镜辅助大多角骨部分切除联合襻钢板悬吊第1掌骨治疗EatonⅡ、Ⅲ期第1腕掌关节炎创伤小、恢复快、并发症少，可保留腕掌关节活动度、维持关节稳定，能够有效缓解疼痛、改善功能。

abstractsObjective:To analyze the clinic effects of arthroscopic partial trapeziectomy and suture button suspensionplasty in the treatment of first carpometacarpal joint (CMCJ) Eaton stage II/III arthrosis.Methods:A retrospective study was conducted on a total of 15 cases (16 hands) of patients including 5 males (1 bilateral) and 10 females with CMCJ stage II/III arthrosis who underwent surgical treatment at the first affiliated hospital of Shenzhen university from January 2020 to June 2022, with mean age of 56.7±6.4 years (range, 46-75 years). The duration from pain to treatment was 7.8±3.2 months (range, 4-14 months). X-ray showed narrowing of CMCJ with osteophytes and distal radial subluxation. All the patients were treated with arthroscopic partial trapeziectomy and suture button suspensionplasty. The preoperative and last postoperative follow-up radiographs, visual analogue scale (VAS), thumb's Kapandji scores, disabilies of the arm, shoulder, and hand (DASH) scores, grip and pinch strength and time to return to work were compared.Results:All cases were followed up for 19.6±6.3 months (range, 11-36 months). The postoperative X-ray showed all the CMCJs were reduced with a normal height of first metacarpal. The mean time for patients to return to their daily activities was 18.69±3.70 d and the mean time to return to work was 24.63±4.91 d. The average VAS score decreased from 6.56±1.15 preoperatively to 1.00 (0.75, 1.25). The preoperative Kapandji's score was 8.00±0.82 and the postoperative Kapandji's score was 8.00 (7.25, 9.00). The average DASH values improved from 24.06±3.19 to 4.00 (3.00, 5.00). The were significant differences except for Kapandji score ( Z=-4.905, P<0.001; Z=-0.121, P=0.905; Z=-4.846, P<0.001). The mean grip and pinch strength showed improvement from an average of 16.4 (14.13, 18.68) kg and 1.70±0.35 kg to 26.14±3.27 kg and 3.58±0.91 kg with significant difference ( Z=-4.617, P<0.001; t=-7.669, P<0.001). Conclusion:Arthroscopic partial trapeziectomy and suture button suspensionplasty is a minimally invasive surgery for the treatment of first CMCJ Eaton stage II/III arthrosis. By this technique, the patients' existing instability and pain problems can be solved.