Arons M S, Fishbone G, Arons J A
Department of Surgery, Hospital of St Raphael, New Haven, CT 06511, USA.
J Hand Surg Am. 1999 Jan;24(1):148-51. doi: 10.1053/jhsu.1999.jhsu24a0148.
Perforations or communicating defects of the triangular fibrocartilage complex have been more commonly identified after Palmer published his classification system (J Hand Surg 1989;14A:594-606). To his variants of class 1B (traumatic) ulnar avulsion with or without distal ulnar fracture, a third category may be added: defects of the ulnar collateral ligament without any associated disruption of the triangular fibrocartilage. The ulnar collateral ligament can be defined as an ulnar capsular structure between the more discrete elements of the triangular fibrocartilage and the ulnar ligaments, with the defect or perforation being distal to the intact triangular fibrocartilage and exiting into the floor of the extensor carpi ulnaris sheath. We present 2 cases that illustrate the diagnosis, the use of both magnetic resonance imaging and arthrography to confirm the diagnosis, the associated dorsal ulnar cutaneous nerve pain distribution, and the open direct and retinacular flap repair.
在帕尔默发表其分类系统后（《手外科杂志》1989年；14A:594 - 606），三角纤维软骨复合体的穿孔或连通性缺损已被更普遍地识别。对于他的1B类（创伤性）尺侧撕脱伴或不伴有尺骨远端骨折的变体，可增加第三类：尺侧副韧带缺损，且三角纤维软骨无任何相关断裂。尺侧副韧带可定义为三角纤维软骨更离散部分与尺侧韧带之间的尺侧关节囊结构，缺损或穿孔位于完整三角纤维软骨的远端，并通向尺侧腕伸肌鞘底部。我们展示2例病例，说明诊断方法、使用磁共振成像和关节造影来确诊、相关的尺背侧皮神经疼痛分布以及开放直接修复和支持带瓣修复。
