CAJ | 학술논문

目的探讨在无Rayhack截骨系统的情况下,应用改良后的尺骨斜形截骨短缩结合腕关节镜治疗尺骨撞击综合征的手术方法,并随访预后.方法 2010年3月至2013年7月,对11例有持续腕尺侧疼痛症状的尺骨正变异患者,行尺骨斜形截骨短缩掌侧加压钢板内固定结合腕关节镜下三角纤维软骨复合体(TFCC)清扫,术后随访观察骨愈合情况,疼痛及功能的改善情况.结果术后随访6个月至2年,平均14个月.骨折愈合时间平均10周.无骨不连发生.术后患者疼痛VAS评分从5.6分降到1.2分.改良Mayo腕功能评分:优6例,良4例,可1例.术后腕关节活动度及握力恢复良好,平均3个月恢复劳动或工作.结论改良尺骨斜形截骨短缩,掌侧加压钢板并使用拉力螺钉可以有效避免骨不连的发生,结合腕关节镜滑膜清扫,是一种治疗尺骨撞击综合征的有效手术方法,减少了骨不连以及背侧钢板突出的缺点,临床效果肯定.
목적 탐토재무Rayhack절골계통적정황하,응용개량후적척골사형절골단축결합완관절경치료척골당격종합정적수술방법,병수방예후.방법 2010년3월지2013년7월,대11례유지속완척측동통증상적척골정변이환자,행척골사형절골단축장측가압강판내고정결합완관절경하삼각섬유연골복합체(TFCC)청소,술후수방관찰골유합정황,동통급공능적개선정황.결과 술후수방6개월지2년,평균14개월.골절유합시간평균10주.무골불련발생.술후환자동통VAS평분종5.6분강도1.2분.개량Mayo완공능평분:우6례,량4례,가1례.술후완관절활동도급악력회복량호,평균3개월회복노동혹공작.결론 개량척골사형절골단축,장측가압강판병사용랍력라정가이유효피면골불련적발생,결합완관절경활막청소,시일충치료척골당격종합정적유효수술방법,감소료골불련이급배측강판돌출적결점,림상효과긍정.
Objective To introduce a modified oblique ulnar shortening technique combined with arthroscopic synovectomy for treating ulnar impingement syndrome without the Rayhack system,and to evaluate the outcomes.Methods From March 2010 to July 2013,11 cases of ulnar positive variance with consistent ulnar wrist pain were treated with oblique osteotomy of the ulna and intemal fixation with a volar Zimmer compression plate.Arthroscopic debridement of the triangular fibrous cartilage complex (TFCC) was also done simultaneously.Postoperatively bone union,wrist pain and wrist function were followed.Results All the cases were follow-up for 6 to 24 months,with an average of 14 months.Average bone union time was 10 weeks.There was no non-union.Postoperative VAS for pain dropped from 5.6 to 1.2.According to Modified Mayo wrist score,the wrist function was excellent in 6 cases,good in 4 cases and fair in 1 case.Wrist range of motion and grip strength recovered well.All the patients went back to previous work in 3 months.Conclusion The modified oblique osteotomy with volar compression plate and lag screw fixation for ulnar shortening combined with arthroscopic synovectomy is an effective treatment for ulnar impingement syndrome.It decreases the incidence of bone nonunion and dorsal implant protruding.