应用尺骨精确截骨短缩术治疗尺骨撞击综合征的临床效果

Effects of precise ulna osteotomy and shortening for ulnar impingement syndrome

目的探讨应用腕关节镜下尺骨精确截骨短缩术治疗尺骨撞击综合征的临床疗效。方法2016年2月至2020年9月苏州大学附属瑞华医院手外科应用腕关节镜下尺骨精确截骨短缩术治疗尺骨撞击综合征患者20例。其中男8例,女12例;年龄(37.0±8.7)(19~54)岁;左侧14例,右侧6例;病程为(12.0±5.3)(1~38)个月。术前通过X线像测量尺骨变异值。术中于腕关节镜下精确测量尺骨变异值并根据测得值行尺骨截骨短缩。采用疼痛视觉模拟评分(VAS)和改良Mayo腕关节评分对患者术前和术后末次随访的腕关节疼痛程度和功能进行评价。应用SPSS 19.0统计软件对数据进行分析。结果术后随访(19.0±5.8)(3~25)个月。所有患者截骨部位均获得骨性愈合,愈合时间为(13±1.8)(11~15)周。术前通过X线像测得与术中腕关节镜下测得尺骨变异值分别为(4.1±1.8)(3~8)和(5.9±1.2)(5~9)mm,差值为(1.8±0.75)(1~3)mm。术前与术后VSA评分分别为(6.4±0.4)和(1.2±0.3)分,改良Mayo腕关节评分分别为(54.4±12.8)和(89.0±8.1)分,差异均有统计学意义(均P<0.05)。结论应用腕关节镜下尺骨精确截骨短缩术治疗尺骨撞击综合征,可获得令人满意的临床疗效。

Objective To investigate the effects of arthroscopic ulnar precise osteotomy and shortening for ulnar impingement syndrome.Method Data of 20 patients with ulnar impingement syndrome underwent using arthroscopic ulnar precise osteotomy and shortening in the Department of Hand Surgery,Ruihua Hospital Affiliated to Soochow University from February 2016 to September 2020 were analyzed retrospectively.There were 8 males and 12 females,with an age of(37.0±8.7)(19-54).There were 14 cases on left side and 6 cases on right side.The duration of disease was(12.0±5.3)(1-38)months.The variation value of ulna were measured by the preoperative X-ray and under the arthroscopy intraoperatively.Visual analogue scale(VAS)and modified Mayo wrist score were used to evaluated the pain and function of wrist befor and after operation.Software of SPSS 19.0 was used to analyze the data statistically.Result The follow-up duration was(19.0±5.8)(3-25)month.All cases achieved bone healing at the osteotomy site,and the healing time of the ulnar bone was(13.0±1.8)(11-15)weeks.The variations of ulna measured via preoperative X-ray and intraoperative arthroscopy were(4.1±1.8)(3~8)mm and(5.9±1.2)(5~9)mm,respectively,and the difference was(1.8±0.75)(1~3)mm.The preoperative and final follow-up VAS scores and improved Mayo wrist scores were 6.4±0.4,1.2±0.3 and 54.4±12.8,89.0±8.1,respectively,and both the differences were statistically significant(all P<0.05).Conclusion Application of precise ulna osteotomy and shortening under arthroscopy in treatment of ulnar impingement syndrome can obtain satisfactory clinical effects.