尺骨短缩截骨治疗特发性尺骨撞击综合征的疗效分析  

Transverse ulnar shortening osteotomy in idiopathic ulnar impaction syndrome： a clinical efficiency study

作　　者：丛晓斌[1] 李涛[1] 季伟[1] 陈燕花[1] 黄启顺[1] 翁雨雄[1] 陈振兵[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院手外科,武汉430022

出　　处：《中华手外科杂志》2013年第1期7-9,共3页Chinese Journal of Hand Surgery

摘　　要：目的探讨尺骨短缩截骨术治疗特发性尺骨撞击综合征的临床疗效。方法对2006年8月至2010年6月间收治的11例尺骨撞击综合征患者（均为单侧病变），采用尺骨横形短缩截骨术治疗。术后随访时问平均为32个月，通过比较其术前术后的尺骨变异值、活动度、握力、视觉模拟评分法（visual analog scale，VhS）以及改良的Mayo腕关节评分和DASH评分六项指标，对该术式临床效果进行评价。结果11例截骨部位均获得骨性愈合。尺骨变异值由术前（2．9±1．3）mill改变为术后（-0．2±0．9）mm。术后腕关节活动度有一定改善，与健侧比较，屈伸活动范围术前（84．9±23．2）％，术后（90．3±13．3）％；旋转活动范围术前（92．2±11．1）％，术后（94．2±9．9）％；尺桡偏范围术前（71．9±11．8）％，术后（81．8±22．7）％。患手占健侧的握力术前（79．7±20．0）％，术后（93．6±8．6）％。VAS疼痛分值术前（7．3±0．7），术后（2．9±1．4）。改良的Mayo腕关节评分术前（59．0±19．0），术后（84．0±21．0），其中优5例，良4例，可2例。DASH得分术前（55．0±20．0），术后（25．0±19．0），其中以反映力量型功能和生活信心的项目改进尤为显著。结论尺骨横形短缩截骨术能够有效改善特发性尺骨撞击综合征患者的腕关节功能，明显减轻疼痛，提高握力，改善生活质量，对腕关节活动范围改善程度有限。Objective To investigate the clinical efficiency of transverse ulnar shortening osteotomy in the treatment of idiopathic ulnar impaction syndrome. Methods From August 2006 to June 2010, 11 patients with idiopathic ulnar impaction syndrome （all of which were unilateral） were treated in our hospital with transverse ostcotomy of the ulna. Postoperative follow-up averaged 32 months. We evaluated the outcomes by means of comparing the postoperative values of ulnar variance, range of motion, grip strength, visual analog scale （VAS）, modified Mayo wrist score, and DASH score with the preoperative ones. Results All patients achieved bone healing. An average preoperative ulnar variance of （2.9 ± 1.3） mm was reduced to （-0.2 ± 0.9） nun postoperatively. The mean range of motion to the contralateral side gained limited increments from （84.9±23.2）% to （90.3 ± 13.3）% for flexion-extension, from （92.2 ± 11.1）% to （94.2 ± 9.9）% for rotation, and from （71.9 ± 11.8）% to （81.8 ＋ 22.7）% for radioulnar deviation. The grip strength to the contralateral side increased from （79.7 ± 20.0）% to （93.6 ± 8.6）% on average. Pain assessment with VAS decreased to （2.9± 1.4）. Compared with preoperative value of （59.0± 19.0）, the modified Mayo wrist score rose to （84.0± 21.0）, with 5 excellent, 4 good and 2 fair results. The DASH value declined from （55.0 ± 20.0） to （25.0±19.0）, especially on items reflecting strength and living confidence. Contusion Ulnar shortening ostcotomy can effectively improve the wrist function, alleviate pain and increase grip strength in patients of idiopathic ulnar impaetion syndrome. It enhances patients＇ quality of life. Yet the improvement on range of motion of the wrist joint is limited.

关 键 词：尺骨 截骨术 治疗结果 尺骨撞击综合征 

分 类 号：R687.3[医药卫生—骨科学]