可延长外固定架辅助下尺骨截骨缩短术治疗重度尺骨正变异  

Extendable External Fixator Assisted Ulnar Osteotomy for Severe Ulnar Positive Variance

作　　者：刘振宇 田甲 王玉凤 李进[1] Liu Zhenyu;Tian Jia;Wang Yufeng;Li Jin(Department of Hand Surgery,Union Hospital,Tongji Medical College of Huazhong University of Science and Technology,Wuhan 430022,China)

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,湖北武汉430022

出　　处：《实用骨科杂志》2023年第2期106-109,共4页Journal of Practical Orthopaedics

摘　　要：目的探讨应用可延长外固定架辅助下,行尺骨截骨缩短术治疗重度尺骨过长(≥10 mm)的方法及疗效。方法选择2018年4月至2020年4月收治的重度尺骨过长腕部疼痛患者共7例,男4例,女3例;年龄19~67岁,平均(43.51±2.26)岁;左侧腕4例,右侧腕3例。所有患者均应用可延长外固定架辅助下的尺骨梯形截骨缩短术治疗,随访应用Cooney腕关节功能评分系统评价治疗效果,从疼痛、功能、活动度及握力四个方面进行手术前后对比。结果所有患者的截骨部位均获得骨性愈合。术后随访6~30个月,平均(17.70±3.31)个月。Cooney腕关节评分术前总评分(45.68±5.16)分;评定结果,可1例,差6例。Cooney腕关节评分术后总评分(90.31±7.30)分;评定结果,优4例,良3例。手术前后腕关节功能评分比较,差异有统计学意义(P<0.05)。手术均达到理想效果。结论通过应用可延长外固定架辅助尺骨截骨缩短术治疗重度尺骨正变异,能有效降低手术难度,并最终缓解腕关节疼痛、握力降低、腕关节活动受限等临床症状。Objective To investigate the method and efficacy of ulnar osteotomy in the treatment of severe ulnar positive variance(≥10mm)with the assistance of extendable external fixator.Methods From April 2018 to April 2020,a total of 7 patients with severe long ulna and wrist pain admitted to our department were selected,including 4 males and 3 females.The years ranged from 19 to 67 years with an average ago of(43.51±2.26)years.There were 4 cases of left wrist and 3 cases of right wrist.All patients were treated with ulna trapezoidal osteotomy assisted by extendable external fixator.The Cooney wrist scoring system was used to evaluate the treatment effect before and after surgery.The pain,function,range of motion and grip strength were observed.Results All osteotomies healed.The postoperative follow-up period was 6 to 30 months,with an average of(17.70±3.31)months.The preoperative score of Cooney wrist score was(45.68±5.16),and the evaluation results were fair in 1 case and poor in 6 cases.The postoperative score was(90.31±7.30),and the evaluation results were excellent in 4 cases and good in 3 cases.These results were significantly different before and after operation(P<0.05).The operation had ideal results.Conclusion The application of extendable external fixator assisted ulnar osteotomy in the treatment of severe ulna positive variation can effectively reduce the difficulty of the operation,and finally relieve the clinical symptoms of wrist pain,grip strength reduction,wrist joint activity limitation.

关 键 词：尺骨正变异 尺骨短缩截骨 可延长外固定架 

分 类 号：R683.41[医药卫生—骨科学]