关节镜下Wafer术治疗尺骨撞击综合征20例临床疗效  

Clinical effect of 20 cases of ulnar impingement syndrome treated by arthroscopic Wafer technique

作　　者：李远 银毅 李清山[1] 何克 冷雨 孙官军[1] 彭旭[1] LI Yuan;YIN Yi;LI Qingshan;HE Ke;LENG Yu;SUN Guanjun;PENG Xu(Orthopedic Center-Joint and Sports Medicine Department,Suining Central Hospital,Suining,Sichuan 629000,China)

机构地区：[1]遂宁市中心医院骨科中心三病区-关节与运动医学科,四川遂宁629000

出　　处：《安徽医药》2025年第1期87-90,I0005,共5页Anhui Medical and Pharmaceutical Journal

基　　金：2023年超声医学工程国家重点实验室开放课题面上项目(2023KFKT024);2023年四川省医学会(青年创新)科研课题基金项目(Q22045)。

摘　　要：目的探讨关节镜下Wafer术治疗腕关节尺骨撞击综合征(UIS)的早期疗效。方法回顾性分析2019年8月至2022年9月遂宁市中心医院收治20例尺骨阳性变异(UV)≤4 mm的UIS病人,均行关节镜下Wafer术治疗,术后行规范的康复性锻炼。男9例,女11例,年龄范围18~76岁,病程范围6~24个月。术前尺骨撞击试验、尺腕压力试验及Press test均为阳性。术前腕关节掌屈、背伸、尺偏、桡偏角度分别为(54.2±3.8)°、(61.1±4.3)°、(15.8±4.6)°、(13.0±2.7)°,疼痛视觉模拟评分法(VAS)、Mayo腕关节评分、上肢功能评分表(DASH)评分、握力、UV程度分别为(6.2±1.1)分、(53.5±9.1)分、(45.9±5.8)分、(60.5±9.3)N,(3.5±1.5)mm。结果病人切口均Ⅰ期愈合,无腕关节僵硬及感染等并发症发生。病人均获随访,随访时间范围为12~24个月。末次随访时腕关节掌屈、背伸分别为(54.7±4.1)°、(61.7±4.6)°,与术前比较均差异无统计学意义(P>0.05);尺偏、桡偏角度分别为(34.4±5.3)°、(15.6±3.5)°,与术前比较均差异有统计学意义(P<0.05);VAS、Mayo腕关节评分、DASH评分、握力、UI分别为(1.6±0.6)分、(81.0±8.3)分、(15.7±4.2)分、(80.8±8.7)N,(0.8±0.8)mm,上述指标与术前比较均差异有统计学意义(P<0.05)。结论关节镜下Wafer手术治疗UV≤4 mm的UIS病人疗效确切,可有效缓解疼痛,改善腕关节功能,值得临床应用及推广。Objective To investigate the early effect of arthroscopic Wafer in the treatment of wrist Ulnar Impaction Syndrome(UIS).Methods A retrospective analysis was performed on 20 UIS patients with positive ulnar variance(UV)≤4 mm admitted to Suining Central Hospital from August 2019 to September 2022.All patients were treated with arthroscopic Wafer surgery and standard rehabilitation exercise after surgery.There were 9 males and 11 females,ranging in age from 18 to 76 years old.The course of disease ranged from 6 to 24 months.Preoperative ulnar impingement test,ulnar pressure test and Press test were positive.Preoperative carpal flexion,dorsalis extension,ulnar deviation and radial deviation were(54.2±3.8)°,(61.1±4.3)°,(15.8±4.6)°,(13.0±2.7)°,respectively.Pain visual analog scale(VAS),Mayo wrist score,DASH score,grip strength,UV degree were(6.2±1.1)points,(53.5±9.1)points,(45.9±5.8)points,(60.5±9.3)N,(3.5±1.5)mm,respectively.Results All the patients´incisions healed in stageⅠ,and no complications such as wrist stiffness and infection occurred.All patients were followed up for 12 to 24 months.At the last follow-up,carpal flexion and dorsiflexion were(54.7±4.1)°and(61.7±4.6)°,respectively,and there was no significant difference compared with the preoperative results(P>0.05);Ulnar deviation and radial deviation were(34.4±5.3)°and(15.6±3.5)°,respectively,and the differences were statistically significant compared with those before surgery(P<0.05);VAS,Mayo wrist score,DASH score,grip strength and UI were(1.6±0.6)points,(81.0±8.3)points,(15.7±4.2)points,(80.8±8.7)N,(0.8±0.8)mm,respectively.The above indexes were statistically significant compared with those before surgery(P<0.05).Conclusion The treatment of UIS patients with UV(≤4 mm)with Wafer surgery under arthroscopy has definite efficacy,can effectively relieve pain and improve wrist joint function,and is worthy of clinical application and promotion.

关 键 词：腕关节 关节镜检查 Wafer术 尺骨撞击综合征 尺骨阳性变异 尺骨撞击试验 尺腕压力试验 

分 类 号：R687.4[医药卫生—骨科学]