腕关节镜辅助2.7 mm钛截骨钢板内固定治疗尺骨撞击综合征  

Wrist arthroscopy combined with 2.7 mm titanium osteotomy plate fixation in treatment of ulnar impaction syndrome

作　　者：陈柯屹[1] 杨顺[1] 程亚博[1] 向往 张静[1] 池昊天 Chen Keyi;Yang Shun;Cheng Yabo;Xiang Wang;Zhang Jing;Chi Haotian(Department of Wrist,Sichuan Provincial Orthopedics Hospital(Chengdu Sports Trauma Research Institute),Chengdu 610041,Sichuan Province,China)

机构地区：[1]四川省骨科医院手腕科(成都运动创伤研究所),四川省成都市610041

出　　处：《中国组织工程研究》2020年第33期5326-5331,共6页Chinese Journal of Tissue Engineering Research

摘　　要：背景:由于缺乏对发病机制的认识,尺骨撞击综合征早期常被统称为腕关节炎,延误患者治疗,引起严重的腕关节功能障碍。目的:回顾性分析腕关节镜辅助下结合2.7 mm钛截骨钢板内固定治疗尺骨撞击综合征的疗效。方法:2017年3月至2019年9月四川省骨科医院手腕科共收治了12例尺骨撞击综合征患者,均采用腕关节镜辅助2.7 mm钛截骨钢板内固定治疗,一并修复腕骨间韧带、关节软骨损伤、三角纤维软骨复合体。对比术前、术后1年尺骨变异值、目测类比评分、改良Mayo腕关节评分进行功能评定。结果与结论:①术后12例患者均获得随访,均达到骨性愈合,愈合时间为5-11个月,平均6个月;②术前X射线片检查尺骨变异值为(3.3±1.3)mm,术后1年为(-0.4±0.6)mm;术前改良Mayo腕关节评分为(59.2±10.6)分,术后1年为(78.3±11.6)分,其中优7例,良4例,可1例;术前目测类比评分为(5.2±0.7)分,术后1年为(3.2±2.5)分,其中9例患者术后疼痛完全缓解,2例明显缓解,上述指标术前及术后差异均有显著性意义(P<0.05);③提示腕关节镜能够明确尺骨撞击综合征的诊断,结合2.7 mm钛截骨钢板内固定可节约手术时间,降低骨不愈合率,术后可缓解腕部疼痛,改善腕关节功能,有利于早期功能锻炼,疗效满意。BACKGROUND: Due to the lack of understanding of the pathogenesis, ulnar impaction syndrome often referred to as carpitis, which delays the treatment of patients and causes severe carpal dysfunction.OBJECTIVE: To retrospectively analyze the effect of arthroscopy combined with 2.7 mm titanium osteotomy plate fixation for treating the ulnar impaction syndrome. METHODS: From March 2017 to September 2019, 12 patients with ulnar impaction syndrome were treated in the Department of Wrist, Sichuan Provincial Orthopedics Hospital. All patients received arthroscopy combined with 2.7 mm titanium osteotomy plate fixation to repair the intercarpal ligament, articular cartilage damage, and trigonal fibrocartilage complex. Ulna variation value, visual analogue scale score, modified Mayo score were compared preoperatively and 1 year postoperatively. RESULTS AND CONCLUSION:(1) All the 12 patients were followed up after the operation, and bone healing was achieved. The healing time was 5-11 months, with an average of 6 months.(2) The ulna variation was(3.3±1.3) mm preoperatively, and(-0.4±0.6) mm postoperatively. The modified Mayo score was(59.2±10.6) preoperatively and(78.3±11.6) 1 year postoperatively. The effect was excellent in seven patients, good in four patients and fair in one patient. Visual analogue scale score was(5.2±0.7) preoperatively and(3.2±2.5) 1 year postoperatively. The pain was completely relieved in nine patients after surgery and significantly relieved in two patients. There were significant differences in the above indexes before and after operation(P<0.05).(3) It is confirmed that wrist arthroscopy can clearly diagnose the ulnar impaction syndrome and the combination with 2.7 mm titanium osteotomy plate can save the operation time, reduce the rate of bone nonunion, relieve the wrist pain and improve the function of the wrist, which is conducive to early functional exercise and satisfactory effect.

关 键 词：骨 钢板 内固定 微创 腕关节镜 尺骨撞击综合征 骨性愈合 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学]