关节镜技术结合尺骨短缩截骨与单纯尺骨短缩截骨治疗尺骨撞击综合征的对比研究

Comparative study on the treatment of ulnar impingement syndrome by arthroscopic technique combined with ulna shortening osteotomy and ulna shortening osteotomy alone

目的比较关节镜技术结合尺骨短缩截骨与单纯尺骨短缩截骨治疗尺骨撞击综合征的疗效差异。方法自2017年5月至2020年5月我科手术治疗尺骨撞击综合征患者78例,其中关节镜技术结合尺骨短缩截骨组(A组)42例,单纯尺骨短缩截骨组(B组)36例。49例无明显外伤史,21例轻微外伤史和8例严重外伤史。术前保守治疗时间3~26个月,平均(8.4±11.5)个月。术后随访时进行疼痛评估,测量前臂旋转及腕关节屈伸活动度和握力,并进行改良Mayo腕关节和DASH上肢功能评分,比较两组间的差异。结果术后随访时间8~38个月,平均(22.3±14.8)个月。根据改良Mayo腕关节功能评分,总体优良率达到92.3%,A组和B组的优良率分别为90.4%和94.4%(P=0.9)。两组间在腕关节屈伸活动,前臂旋转,手部握力,疼痛评分,改良Mayo腕关节评分和DASH上肢功能评分方面差异均无统计学意义(P>0.05)。结论仑关节镜技术结合尺骨短缩截骨和单纯尺骨短缩截骨均能有效治疗尺骨撞击综合征,两种方式的疗效相同。

Objective To compare the clinical efficacy of arthroscopy combined with ulna shortening osteotomy and ulna shortening osteotomy alone in the treatment of ulnar impingement syndrome.Methods From May 2017 to May 2020,78 patients with ulnar impingement syndrome were surgically treated in our department,including 42 cases in the arthroscopic technique combined with ulna shortening osteotomy group(group A)and 36 cases in the simple ulna shortening osteotomy group(group B).49 cases had no obvious history of trauma,21 cases had a history of minor trauma and 8 cases had a history of severe trauma.The duration of preoperative conservative treatment was 3 to 26 months,with an average of(8.4±11.5)months.During the follow-up after operation,pain was assessed,forearm rotation,wrist flexion and extension mobility and grip strength were measured,and modified Mayo wrist and DASH upper limb function scores were performed to compare the differences between the two groups.ResultsThe follow-up period was 8 to 38 months,with an average of(22.3±14.8)months.According to the modified Mayo wrist function score,the overall excellent and good rate reached 92.3%,and the excellent and good rates of group A and group B were 90.4%and 94.4%respectively(P=0.9).There was no significant difference between the two groups in wrist flexion and extension,forearm rotation,hand grip strength,pain score,modified Mayo wrist score and DASH upper limb function score(P>0.05).Conclusion The arthroscopy combined with ulna shortening osteotomy and simple ulna shortening osteotomy can effectively treat ulnar impingement syndrome,and the two methods have the same effect.