儿童桡骨远端骨骺损伤致尺骨撞击征一例报告

Juvenile ulnar impingement caused by distal radial epiphyseal injuries:1 case report

尺骨撞击综合征是由于腕尺侧月骨、三角骨与尺骨头撞击所引起的腕部创伤性关节病,其病理过程早期为软骨改变、骨髓水肿,晚期可导致不可逆性骨坏死及骨关节炎,导致严重的功能障碍[1]。随着临床医生对该病的认识不断提高,国内外相关报道也逐渐增多,但仍有部分临床医生及影像科医生对此征的认识不足,导致诊治不及时等情况发生。尤其是儿童桡骨远端骨骺损伤的患儿。

To investigate the clinical characteristics of ulnocarpal impingement syndrome in children induced by distal radial epiphyseal injuries in long term. A retrospective analysis of one child with distal radial epiphyseal injuries combined with dislocations was performed. The child had a sore wrist at 6 years after manual reduction. The diagnosis of ulnar impingement was conifrmed according to the patient history, symptoms, physical signs and radiological examinations of bilateral wrist joints. Ulnar impingement would occur in children with distal radial epiphyseal injuries in long term. Repeated manual reduction should be avoided in children with distal radial epiphyseal injuries, in order to minimize secondary epiphyseal injuries and reduce the risk of early epiphyseal closure. Furthermore, the growth imbalance of the ulna and radius in long term would be avoided and the risk of ulnar impingement in the wrist joint would be reduced. Clinical surgeons should pay great attention to the early diagnose and treatmont which could signiifcantly lower the disability rate.