腕关节镜清创治疗尺骨撞击综合征的疗效对比分析  

Comparative analysis of the efficacy of wrist arthroscopic debridement in the treatment of ulnar impact syndrome

作　　者：夏雷 毕文超 杨瑞泽 高磊[1] 李嘉庚 李鹏[1] 许玉本 Xia Lei;Bi Wenchao;Yang Ruize;Gao Lei;Li Jiageng;Li Peng;Xu Yuben(Department of Hand Surgery,Xi′an Honghui Hospital Affiliated to Xi′an Jiaotong University,Xi′an 710054,China)

机构地区：[1]西安交通大学附属西安市红会医院手外科,西安710054

出　　处：《中华手外科杂志》2024年第1期44-47,共4页Chinese Journal of Hand Surgery

摘　　要：目的比较单纯尺骨短缩截骨(ulnar shortening osteotomy,USO)与同时进行腕关节镜清理术(arthroscopic debridement,AD)治疗尺骨撞击综合征的短期临床疗效。方法我科自2017年8月至2021年4月收治52例诊断为尺骨撞击综合征并计划行USO的患者,20例采用单纯USO,32例采用USO联合腕关节AD。分别记录手术前、后尺骨变异,术后采用疼痛视觉模拟评分(visual analogue scale,VAS)及改良的Mayo腕关节评分对手术疗效进行评价。结果在术后12、24个月的随访中,USO组和腕关节AD组的疼痛VAS和DASH评分均有显著的临床改善(P<0.01)。但在随访3个月时,AD组的疼痛VAS评分明显改善;两组患者在3、12和24个月时的DASH评分中,以及在12、24个月随访时的疼痛VAS评分中,均未发现显著差异。结论单纯USO与同时进行腕关节AD治疗尺骨撞击综合征两种方法,在改善患者手部功能和缓解疼痛方面都有很好的疗效;但短期缓解腕部疼痛方面,USO结合腕关节AD疗效更优。Objective To compare the short-term clinical efficacy of simple ulnar shortening osteotomy(USO)versus USO combined with arthroscopic debridement(AD)in the treatment of ulnar impaction syndrome.Methods From August 2017 to April 2021,52 patients diagnosed with ulnar impact syndrome and planned to undergo USO were treated in our department.20 patients underwent simple USO,and 32 patients underwent USO combined with wrist AD.The variations of the ulna before and after surgery were recorded,and the surgical efficacy was evaluated using the visual analog scale(VAS)and modified Mayo wrist joint score after surgery.Results During follow-up at 12 and 24 months after surgery,there were significant clinical improvements in pain VAS and DASH scores in the USO and wrist AD groups(P<0.01).However,at a follow-up of 3 months,the pain VAS in the AD group significantly improved.There were no significant differences between the two groups of patients in DASH scores at 3,12,and 24 months,as well as in pain VAS at 12 and 24 months of follow-up.Conclusion Both simple USO and simultaneous wrist AD are effective methods in improving hand function and alleviating pain in patients with ulnar impact syndrome.However,in terms of short-term relief of wrist pain,USO combined with wrist AD has better clinical efficacy.

关 键 词：关节镜 对比研究 尺骨撞击 截骨短缩 

分 类 号：R687.4[医药卫生—骨科学]