CAJ | 학술논문

目的探讨尺骨短缩术治疗尺骨撞击综合征术前、术后影像学变化及临床意义.方法对2008年8月至2011年11月诊断为尺骨撞击综合征在我院治疗的14例16腕患者,采用尺骨短缩截骨术治疗.术后平均随访24.2个月,通过比较其术前、术后X线片及MRI的变化并分析其临床意义.结果 16例截骨部位均获得骨性愈合.尺骨变异值由术前的(4.20±1.70)mm变为术后的(0.05±1.10)mm.7腕术前X线片出现骨质改变,术后5腕骨密度基本恢复正常;6腕术前出现桡尺远侧关节半脱位的患者术后关节半脱位情况得到明显改善;2腕出现桡尺远侧关节炎;1腕发生腕关节不稳伴月骨坏死.8腕MRI术前、术后腕骨不同程度的信号改变,主要表现为术前长T1、长T2信号,术后5腕信号基本恢复正常,3腕在术后T1上低信号病灶内见骨髓样高信号区.结论绝大多数尺骨撞击综合征存在月骨、三角骨或尺骨小头X线片上骨质改变或MPI信号异常,在行尺骨短缩术后常能恢复正常,但仍需警惕术后桡尺远侧关节炎和月骨坏死的发生.
목적 탐토척골단축술치료척골당격종합정술전、술후영상학변화급림상의의.방법 대2008년8월지2011년11월진단위척골당격종합정재아원치료적14례16완환자,채용척골단축절골술치료.술후평균수방24.2개월,통과비교기술전、술후X선편급MRI적변화병분석기림상의의.결과 16례절골부위균획득골성유합.척골변이치유술전적(4.20±1.70)mm변위술후적(0.05±1.10)mm.7완술전X선편출현골질개변,술후5완골밀도기본회복정상;6완술전출현뇨척원측관절반탈위적환자술후관절반탈위정황득도명현개선;2완출현뇨척원측관절염;1완발생완관절불은반월골배사.8완MRI술전、술후완골불동정도적신호개변,주요표현위술전장T1、장T2신호,술후5완신호기본회복정상,3완재술후T1상저신호병조내견골수양고신호구.결론 절대다수척골당격종합정존재월골、삼각골혹척골소두X선편상골질개변혹MPI신호이상,재행척골단축술후상능회복정상,단잉수경척술후뇨척원측관절염화월골배사적발생.
Objective To investigate the pre-and post-operative radiographic changes and clinical significance of ulnar shortening in the treatment of ulnar impaction syndrome.Methods Between August 2008 and November 2011,16 wrists of 14 patients were diagnosed with ulnar impaction syndrome were treated with ulnar shortening osteotomy.Postoperatively the patients were follow-up for a mean of 24.2 months.The pre-and postoperative X-rays and MRI images were compared to analyze the clinical significance of these changes.Results Bone union was achieved at the osteotomy site in all 16 cases.The degree of ulnar variance changed from (4.20 ± 1.70) mm preoperatively to (0.05 ± 1.10) mm postoperatively.Of the 7 wrists that had preoperative bone density changes,5 had near normal density of the carpal bones postoperatively.Subluxation of the distal radioulnar joint in 6 wrists was greatly improved after the operation.Two wrists developed arthritis of the distal radioulnar joint,while 1 wrist had wrist instability and lunate necrosis.MRI signal changes in the carpal bones were noted in 8 wrists.These were manifested as preoperative long T1 and long T2 signals.Postoperatively MRI signals returned to normal in 5 wrists,while myeloid high-intensity zone was present in low-intensity lesions on T1 in 3 wrists.Conclusion Most ulnar impaction syndrome cases have X-ray changes or MRI signal abnormalities in lunate,triangular bone or capitulum ulnae.These changes will return to normal after ulnar shortening osteotomy.However the occurrence of distal radioulnar joint arthritis and lunate necrosis should not be overlooked.