预钻孔斜形尺骨截骨短缩术治疗尺骨撞击综合征的临床疗效分析  

Clinical efficacy analysis of oblique ulnar shortening osteotomy using predrilled hole method for treatment of ulnar impaction syndrome

作　　者：尹善青[1] 王欣[1] 潘佳栋[1] 黄耀鹏[1] 丁文全[1] 周丹亚[1] 王胜伟[1] 王科杰[1] 郭浩[1] 

机构地区：[1]宁波市第六医院手外科,浙江315000

出　　处：《中华手外科杂志》2017年第6期444-446,共3页Chinese Journal of Hand Surgery

摘　　要：目的探讨预钻孔斜形尺骨截骨短缩术治疗尺骨撞击综合征的临床疗效。方法自2012年5月至2015年7月，我们采用预钻孔斜形尺骨截骨短缩术治疗35例尺骨撞击综合征患者，记录手术时间，比较术前、术后的疼痛及功能恢复情况，根据VAS评分以及改良的Mayo腕关节评分和上肢功能评价表（DASH）对临床效果进行评价。结果平均手术时间45．7min（32～60min），术后平均随访时间15个月（6。36个月），所有病例截骨部位均获得骨性愈合，平均愈合时间为12周，VAS评分由术前（7．4±0．6）分改善为术后（2．8±1．3）分，差异有统计学意义（P〈O．05），改良的Mayo腕关节评分由术前（53．0±16．3）分提高至术后（84．0±10．2）分，差异有统计学意义（P〈0．05），其中优23例，良10例，可2例。DASH评分由术前（57．0±18．2）分降低至术后（26．1±18．5）分，差异有统计学意义俨〈0．05），5例患者术后有钢板激惹症状。结论预钻孔斜形尺骨截骨短缩术能减少软组织的损伤，截骨的骨愈合率较高，并发症较少，能明显改善患者的症状，实现与采用截骨工具截骨同样满意的临床效果。Objective To investigate the clinical efficacy of oblique ulnar shortening osteotomy using predrilled hole method in the treatment of ulnar impaction syndrome. Methods From May 2012 to July 2015, 35 cases of ulnar irnpaction syndrome were treated by oblique ulnar shortening osteotomy using predrilled hole method. The operation time was recorded, and the pain and functional recovery before and after the operation were compared. The clinical outcomes were evaluated according to the VAS score, the modified Mayo wrist score and the disabilities of the arm, shoulder and hand （DASH） questionnaire. Results The average operation time was 45.7 min （range, 32 to 60 min）. All the patients were follow-up for 6 to 36 months with an average of 15 months. The osteotomy site achieved bone healing in all cases with the average healing time being 12 weeks. Postoperative VAS score reduced from 7.4±0.6 to 2.8±1.3. Modified Mayo wrist score increased from 53.0±16.3 to 84.0±10.2. The results were excellent in 23 cases, good in 10 cases and fair in 2 cases. DASH value declined from 57.0±18.2 to 26.1±18.5. The differences were all statistically significant （P〈0.05）. Postoperative plate irritation occurred in 5 patients. Conelusion Oblique ulnar shortening osteotomy using predrilled hole method can reduce the soft tissue injury with higher bone healing rate and less complications and achieve the same clinical effects as application of osteotomy instruments.

关 键 词：尺骨 治疗结果 截骨 尺骨撞击综合征 

分 类 号：R687.3[医药卫生—骨科学]