尺骨斜形截骨短缩术治疗尺腕撞击综合征的疗效分析  

Effect Analysis of Ulnar Shortening Oblique Osteotomy for Ulnar Impaction Syndrome

作　　者：冒海军[1] 许光跃[1] Mao Haijun;Xu Guangyue(Nanjing Drum Tower Hospital,The Affiliated Hospital of Nanjing University Medical School,Nanjing 210008,China)

机构地区：[1]南京大学医学院附属南京鼓楼医院骨科,江苏南京210008

出　　处：《实用骨科杂志》2022年第9期774-777,共4页Journal of Practical Orthopaedics

摘　　要：目的探讨尺骨斜形截骨短缩术治疗尺腕撞击综合征的临床疗效。方法2014年1月至2018年12月,应用尺骨斜形截骨短缩术治疗尺腕撞击综合征患者41例,男19例,女22例;年龄21~74岁,平均(45±14)岁。统计分析患者的一般资料,术前术后的尺骨变异值、桡尺距离、疼痛视觉模拟评分(visual analogue scale,VAS)和改良的Mayo腕关节评分,进行临床综合分析。结果所有切口术后I期愈合。随访时间16~24个月,平均(20±2)个月。尺骨变异长度由术前平均(3.4±0.8)mm变为术后平均(-1.7±1.0)mm。6例患者存在尺骨向背侧半脱位,术前桡尺距离平均为(7.1±2.5)mm,术后桡尺距离平均为(2.8±0.7)mm。VAS评分由术前的平均(4.6±1.2)分降为术后的(2.1±1.7)分。改良Mayo腕关节评分由术前的平均(60.0±12.9)分上升为术后的平均(83.3±15.2)分。结论治疗早期尺腕撞击综合征,尺骨斜形截骨短缩术可以取得满意疗效,同时可以纠正下尺桡关节脱位。对于病程长或伴有关节炎表现的患者,其效果有限。Objective To evaluate the clinical experience of ulnar shortening oblique osteotomy for ulnar impaction syndrome.Methods From January 2014 to December 2018,41 patients with ulnar impaction syndrome underwent ulnar shortening osteotomy,including 19 males and 22 females with an average age of(45±14)years(rang 21~74 years).We analyzed the general dates of all patients,evaluated the outcomes of postoperative values of ulnar variance,radiounlar distance,visual analog scale(VAS),and modified Mayo wrist score by comparing with the preoperative ones.Results All patients had primary healing.All cases were followed up for(20±2)months(range 16~24 months).An average preoperative ulnar variance of(3.4±0.8)mm was reduced to(-1.7±1.0)mm postoperatively.6 had dorals ulnar dislocation,an average preoperative radioulnar distance of(7.1±2.5)mm was reduced to(2.8±0.7)mm postoperatively.The VAS score was reduced from preoperative(4.6±1.2)to postoperative(2.1±1.7).The average Mayo wrist score was improved from(60.0±12.9)before surgery to(83.3±15.2)after surgery.Conclusion Ulnar shortening oblique osteotomy can reach satisfactory effects for early ulnar impaction syndrome,and can correct dislocation of distal radiounlnar joint.However,clinical efficacy remains controversial in patients with long course or arthritis.

关 键 词：尺腕撞击综合征 尺骨斜形截骨短缩术 疗效分析 

分 类 号：R681.7[医药卫生—骨科学]