尺骨短缩截骨治疗特发性尺骨撞击综合征的疗效分析

Analysis of Curative Effect of Ulna Shortening Osteotomy in Treatment of Idiopathic Ulnar Impaction Syndrome

目的探讨特发性尺骨撞击综合征采用尺骨短缩截骨治疗的疗效。方法选取50例于2010年4月—2011年4月期间该院接收的特发性尺骨撞击综合征患者,均给予尺骨短缩截骨术治疗,观察术前术后患者尺骨变异值、腕关节活动度、握力占健侧百分比、腕部活动时疼痛程度、腕关节功能、上肢功能变化。结果 50例患者中,有1例伤口愈合缓慢,活动疼痛,出现皮下血肿,皮肤瘢痕增生明显,无感染病例;与术前尺骨变异值(2.9±1.2)比较,患者术后明显降低为负值,为(-0.3±0.8),且患者术后较术前握力恢复明显,术前、术后握力值分别为(79.6±15.3)、(93.6±2.1),(P<0.05);与术前比较,术后患者腕关节活动度改善有限,其中仅术后尺桡偏范围、屈伸活动分别为(92.3±9.4)、(81.9±12.7)均较术前分别为(81.5±9.6)、(71.3±11.5)显著增加,差异有统计学意义(P<0.05);患者腕关节术后疼痛改善明显,为(2.8±1.3)分,与术前疼痛值(7.2±0.6)分比较差异有统计学意义(P<0.05);且术后患者改良Mayo腕关节评分值(84.2±13.2)分较术前(59.2±15.3)分明显增加(P<0.05);此外术后患者DASH评分(55.1±18.5)分较术前(25.1±8.7)分显著降低(P<0.05)。结论特发性尺骨撞击综合征采用尺骨短缩截骨术能有效减轻患者疼痛,改善腕关节功能,提高握力,具有推广意义。

Objective To study the curative effect of ulna shortening osteotomy in treatment of Idiopathic ulnar im-paction syndrome. Methods 5 0 cases of patients with idiopathic ulnar impaction syndrome admitted and treated in our hospital from April 2010 to April 2011 were selected and treated with ulna shortening osteotomy, and the ulna devia-tion value, wrist joint activity, percentage of grip strength in contralateral side, pain degree at wrist activity, wrist joint function and change of upper limb function of patients before and after operation were observed. Results Of 5 0 cases of patients, there was 1 case whose wound was slowly cured, and the swelling subcutaneous hematoma and skin hyper-trophic scar were obvious, and there were no infection cases , and the ulna deviation value of patients after operation obviously decreased to the negative value compared with that before operation （2.9±1.2）vs （ -0.3±0.8） , and the gripstrength recovery after operation was more obvious than that before operation, and the grip strength values before and after operation were respectively （79.6±15.3）and （93.6±2.1）, all （P〈0.05）, and the improvement of wrist joint activity of patients after operation was limited, and the radial/ulnar deviation range and f lexion-extens ion after operation were ob-viously increased compared with those before operation（92.3±9.4）、 （81 .9±1 2.7） vs （8 1 .5 ± 9 .6 ）、 （71.3±11.5） （P〈0.05）, and the difference was obvious, and the improvement of postoperative pains of wrist joint was obvious, which was （2.8±1.3） points, and the difference before operation and after operation was obvious, which was （7.2±0.6）points after operation（P〈0.05）, and the modified Mayo wrist joint score after operation was obviously increased compared with that before opera-tion （84.2±13.2）points vs （59.2±15.3）points（P〈0.05）, besides, the DASH score of patients after operation was obviously decreased compared with that before operation（55.1±18.5）points vs （25.1±8.7）points（P〈0.05）. Conclusion Ulna short-ening osteotomy in treatment of idiopathic ulnar impaction syndrome can effectively relieve the pains of patients, im-prove the wrist joint function and improve the grip strength, which is worth promotion.