中华手外科杂志
中華手外科雜誌
중화수외과잡지
CHINESE JOURNAL OF HAND SURGERY
2013年
1期
7-9
,共3页
丛晓斌%李涛%季伟%陈燕花%黄启顺%翁雨雄%陈振兵
叢曉斌%李濤%季偉%陳燕花%黃啟順%翁雨雄%陳振兵
총효빈%리도%계위%진연화%황계순%옹우웅%진진병
尺骨%截骨术%治疗结果%尺骨撞击综合征
呎骨%截骨術%治療結果%呎骨撞擊綜閤徵
척골%절골술%치료결과%척골당격종합정
Ulna%Osteotomy%Treatment outcome%Ulnar impaction syndrome
目的 探讨尺骨短缩截骨术治疗特发性尺骨撞击综合征的临床疗效.方法 对2006年8月至2010年6月间收治的11例尺骨撞击综合征患者(均为单侧病变),采用尺骨横形短缩截骨术治疗.术后随访时间平均为32个月,通过比较其术前术后的尺骨变异值、活动度、握力、视觉模拟评分法(visual analog scale,VAS)以及改良的Mayo腕关节评分和DASH评分六项指标,对该术式临床效果进行评价.结果 11例截骨部位均获得骨性愈合.尺骨变异值由术前(2.9±1.3) mm改变为术后(-0.2±0.9) mm.术后腕关节活动度有一定改善,与健侧比较,屈伸活动范围术前(84.9±23.2)％,术后(90.3±13.3)％；旋转活动范围术前(92.2±11.1)％,术后(94.2±9.9)％；尺桡偏范围术前(71.9±11.8)％,术后(81.8±22.7)％.患手占健侧的握力术前(79.7±20.0)％,术后(93.6±8.6)％.VAS疼痛分值术前(7.3±0.7),术后(2.9±1.4).改良的Mayo腕关节评分术前(59.0±19.0),术后(84.0±21.0),其中优5例,良4例,可2例.DASH得分术前(55.0±20.0),术后(25.0±19.0),其中以反映力量型功能和生活信心的项目改进尤为显著.结论 尺骨横形短缩截骨术能够有效改善特发性尺骨撞击综合征患者的腕关节功能,明显减轻疼痛,提高握力,改善生活质量,对腕关节活动范围改善程度有限.
目的 探討呎骨短縮截骨術治療特髮性呎骨撞擊綜閤徵的臨床療效.方法 對2006年8月至2010年6月間收治的11例呎骨撞擊綜閤徵患者(均為單側病變),採用呎骨橫形短縮截骨術治療.術後隨訪時間平均為32箇月,通過比較其術前術後的呎骨變異值、活動度、握力、視覺模擬評分法(visual analog scale,VAS)以及改良的Mayo腕關節評分和DASH評分六項指標,對該術式臨床效果進行評價.結果 11例截骨部位均穫得骨性愈閤.呎骨變異值由術前(2.9±1.3) mm改變為術後(-0.2±0.9) mm.術後腕關節活動度有一定改善,與健側比較,屈伸活動範圍術前(84.9±23.2)％,術後(90.3±13.3)％；鏇轉活動範圍術前(92.2±11.1)％,術後(94.2±9.9)％；呎橈偏範圍術前(71.9±11.8)％,術後(81.8±22.7)％.患手佔健側的握力術前(79.7±20.0)％,術後(93.6±8.6)％.VAS疼痛分值術前(7.3±0.7),術後(2.9±1.4).改良的Mayo腕關節評分術前(59.0±19.0),術後(84.0±21.0),其中優5例,良4例,可2例.DASH得分術前(55.0±20.0),術後(25.0±19.0),其中以反映力量型功能和生活信心的項目改進尤為顯著.結論 呎骨橫形短縮截骨術能夠有效改善特髮性呎骨撞擊綜閤徵患者的腕關節功能,明顯減輕疼痛,提高握力,改善生活質量,對腕關節活動範圍改善程度有限.
목적 탐토척골단축절골술치료특발성척골당격종합정적림상료효.방법 대2006년8월지2010년6월간수치적11례척골당격종합정환자(균위단측병변),채용척골횡형단축절골술치료.술후수방시간평균위32개월,통과비교기술전술후적척골변이치、활동도、악력、시각모의평분법(visual analog scale,VAS)이급개량적Mayo완관절평분화DASH평분륙항지표,대해술식림상효과진행평개.결과 11례절골부위균획득골성유합.척골변이치유술전(2.9±1.3) mm개변위술후(-0.2±0.9) mm.술후완관절활동도유일정개선,여건측비교,굴신활동범위술전(84.9±23.2)％,술후(90.3±13.3)％；선전활동범위술전(92.2±11.1)％,술후(94.2±9.9)％；척뇨편범위술전(71.9±11.8)％,술후(81.8±22.7)％.환수점건측적악력술전(79.7±20.0)％,술후(93.6±8.6)％.VAS동통분치술전(7.3±0.7),술후(2.9±1.4).개량적Mayo완관절평분술전(59.0±19.0),술후(84.0±21.0),기중우5례,량4례,가2례.DASH득분술전(55.0±20.0),술후(25.0±19.0),기중이반영역량형공능화생활신심적항목개진우위현저.결론 척골횡형단축절골술능구유효개선특발성척골당격종합정환자적완관절공능,명현감경동통,제고악력,개선생활질량,대완관절활동범위개선정도유한.
Objective To investigate the clinical efficiency of transverse ulnar shortening osteotomy in the treatment of idiopathic ulnar impaction syndrome.Methods From August 2006 to June 2010,11 patients with idiopathic ulnar impaction syndrome (all of which were unilateral) were treated in our hospital with transverse osteotomy of the ulna.Postoperative follow-up averaged 32 months.We evaluated the outcomes by means of comparing the postoperative values of ulnar variance,range of motion,grip strength,visual analog scale (VAS),modified Mayo wrist score,and DASH score with the preoperative ones.Results All patients achieved bone healing.An average preoperative ulnar variance of (2.9 ± 1.3) mm was reduced to (-0.2 ±0.9) mm postoperatively.The mean range of motion to the contralateral side gained limited increments from (84.9±23.2)％ to (90.3 ± 13.3)％ for flexion-extension,from (92.2 ± 11.1)％ to (94.2 ± 9.9)％ for rotation,and from (71.9 ± 11.8)％ to (81.8 ± 22.7)％ for radioulnar deviation.The grip strength to the contralateral side increased from (79.7 ± 20.0)％ to (93.6 ± 8.6)％ on average.Pain assessment with VAS decreased to (2.9± 1.4).Compared with preoperative value of (59.0± 19.0),the modified Mayo wrist score rose to (84.0±21.0),with 5 excellent,4 good and 2 fair results.The DASH value declined from (55.0± 20.0) to (25.0± 19.0),especially on items reflecting strength and living confidence.Conclusion Ulnar shortening osteotomy can effectively improve the wrist function,alleviate pain and increase grip strength in patients of idiopathic ulnar impaction syndrome.It enhances patients' quality of life.Yet the improvement on range of motion of the wrist joint is limited.
