Wrist tuberculosis-experience from eighteen cases: a retrospective study
Abstract Background Wrist tuberculosis is a rare disease, which is easy to be misdiagnosed, leading to delayed treatment and poor prognosis. In this study, the clinical manifestations, diagnosis, treatment, and prognosis of 18 cases of wrist tuberculosis were analyzed retrospectively. Methods A retr...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-01-01
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| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13018-020-02198-0 |
| _version_ | 1811186031419981824 |
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| author | Longfei Zou Xing Guo Hao Xue Denghua Huang Hui Lv Meiyun Tan |
| author_facet | Longfei Zou Xing Guo Hao Xue Denghua Huang Hui Lv Meiyun Tan |
| author_sort | Longfei Zou |
| collection | DOAJ |
| description | Abstract Background Wrist tuberculosis is a rare disease, which is easy to be misdiagnosed, leading to delayed treatment and poor prognosis. In this study, the clinical manifestations, diagnosis, treatment, and prognosis of 18 cases of wrist tuberculosis were analyzed retrospectively. Methods A retrospective study was conducted, investigating tuberculosis of the wrist, diagnosed in 18 patients from August 2013 to November 2018. Puncture biopsy confirmed the diagnosis. The study includes 11 males and 7 females, and 8 left and 10 right wrists. The average age was 53.5 ± 18.3 years and ranged from 15 to 81 years. The disease course was 1 to 42 months, with an average of 15.1 ± 11.3 months. Eighteen patients were underwent surgery and chemotherapy, 3 patients with severe bone defects were treated with wrist fusion, and 15 patients were underwent focus removal. The Gartland and Werley score, DASH score, the range of motion (ROM), grip strength, and imaging examinations were used to evaluate the postoperative recovery of the patients. Results Eighteen patients were followed up for 15 to 77 months, with an average follow up of 39.7 ± 15.3 months. The ESR and CRP levels were normal for all patients after chemotherapy. No recurrence of tuberculosis was observed in any of the patients. Among the 15 focus removals, the Gartland and Werley scores at admission, two weeks of chemotherapy, 1 month after surgery, and the last follow-up were 21.73 ± 4.33, 18.60 ± 3.16,11.27 ± 2.79, and 5.07 ± 2.28, respectively; and the DASH scores were 45.87 ± 5.58, 39.47 ± 4.72, 22.67 ± 6.54, and 6.73 ± 2.94, respectively. The range of motion (ROM) of the wrist and grip strength improved significantly when compared to those at admission. Among the three cases of wrist fusion, 2 were fixed with a steel plate and the fixation position of wrist joint was good. One case was fixed with Kirschner wire and resulted in a slightly deformed wrist joint. Conclusion For patients with wrist tuberculosis, early diagnosis, preoperative and postoperative chemotherapy, thorough focus removal, and appropriate fixation of the affected limb can help restore the function of the affected wrist, reduce the recurrence rate, and improve the quality of life. |
| first_indexed | 2024-04-11T13:39:30Z |
| format | Article |
| id | doaj.art-1ab44c03c56d40668363ab26a52feac9 |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-11T13:39:30Z |
| publishDate | 2021-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-1ab44c03c56d40668363ab26a52feac92022-12-22T04:21:17ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2021-01-0116111010.1186/s13018-020-02198-0Wrist tuberculosis-experience from eighteen cases: a retrospective studyLongfei Zou0Xing Guo1Hao Xue2Denghua Huang3Hui Lv4Meiyun Tan5Department of Orthopedic Surgery, The Affiliated Hospital of Southwest Medical UniversityDepartment of Orthopedic Surgery, The Affiliated Hospital of Southwest Medical UniversityDepartment of Orthopedic Surgery, The Affiliated Hospital of Southwest Medical UniversityDepartment of Orthopedic Surgery, The Affiliated Hospital of Southwest Medical UniversityDepartment of Orthopedic Surgery, The Affiliated Hospital of Southwest Medical UniversityDepartment of Orthopedic Surgery, The Affiliated Hospital of Southwest Medical UniversityAbstract Background Wrist tuberculosis is a rare disease, which is easy to be misdiagnosed, leading to delayed treatment and poor prognosis. In this study, the clinical manifestations, diagnosis, treatment, and prognosis of 18 cases of wrist tuberculosis were analyzed retrospectively. Methods A retrospective study was conducted, investigating tuberculosis of the wrist, diagnosed in 18 patients from August 2013 to November 2018. Puncture biopsy confirmed the diagnosis. The study includes 11 males and 7 females, and 8 left and 10 right wrists. The average age was 53.5 ± 18.3 years and ranged from 15 to 81 years. The disease course was 1 to 42 months, with an average of 15.1 ± 11.3 months. Eighteen patients were underwent surgery and chemotherapy, 3 patients with severe bone defects were treated with wrist fusion, and 15 patients were underwent focus removal. The Gartland and Werley score, DASH score, the range of motion (ROM), grip strength, and imaging examinations were used to evaluate the postoperative recovery of the patients. Results Eighteen patients were followed up for 15 to 77 months, with an average follow up of 39.7 ± 15.3 months. The ESR and CRP levels were normal for all patients after chemotherapy. No recurrence of tuberculosis was observed in any of the patients. Among the 15 focus removals, the Gartland and Werley scores at admission, two weeks of chemotherapy, 1 month after surgery, and the last follow-up were 21.73 ± 4.33, 18.60 ± 3.16,11.27 ± 2.79, and 5.07 ± 2.28, respectively; and the DASH scores were 45.87 ± 5.58, 39.47 ± 4.72, 22.67 ± 6.54, and 6.73 ± 2.94, respectively. The range of motion (ROM) of the wrist and grip strength improved significantly when compared to those at admission. Among the three cases of wrist fusion, 2 were fixed with a steel plate and the fixation position of wrist joint was good. One case was fixed with Kirschner wire and resulted in a slightly deformed wrist joint. Conclusion For patients with wrist tuberculosis, early diagnosis, preoperative and postoperative chemotherapy, thorough focus removal, and appropriate fixation of the affected limb can help restore the function of the affected wrist, reduce the recurrence rate, and improve the quality of life.https://doi.org/10.1186/s13018-020-02198-0WristTuberculosisOsteoarticularOrthopedic proceduresChemotherapyAdjuvant |
| spellingShingle | Longfei Zou Xing Guo Hao Xue Denghua Huang Hui Lv Meiyun Tan Wrist tuberculosis-experience from eighteen cases: a retrospective study Journal of Orthopaedic Surgery and Research Wrist Tuberculosis Osteoarticular Orthopedic procedures Chemotherapy Adjuvant |
| title | Wrist tuberculosis-experience from eighteen cases: a retrospective study |
| title_full | Wrist tuberculosis-experience from eighteen cases: a retrospective study |
| title_fullStr | Wrist tuberculosis-experience from eighteen cases: a retrospective study |
| title_full_unstemmed | Wrist tuberculosis-experience from eighteen cases: a retrospective study |
| title_short | Wrist tuberculosis-experience from eighteen cases: a retrospective study |
| title_sort | wrist tuberculosis experience from eighteen cases a retrospective study |
| topic | Wrist Tuberculosis Osteoarticular Orthopedic procedures Chemotherapy Adjuvant |
| url | https://doi.org/10.1186/s13018-020-02198-0 |
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