Watson H K, Weinzweig J
Connecticut Combined Hand Service, Hartford Hospital, USA.
J Hand Surg Br. 1999 Jun;24(3):321-4. doi: 10.1054/jhsb.1999.0070.
Ulnar-wrist pain is a complex problem whose cause often remains elusive. A diagnostic triad of localized triquetral pain, history of a wrist hyperflexion injury, and normal radiographs, accompanied by ulnar wrist swelling and limited wrist motion, is often attributable to a syndrome we have termed triquetral impingement ligament tear (TILT). The mechanism of injury causes a cuff of fibrous tissue to be displaced distally from the ulnar sling mechanism, resulting in chronic impingement on the triquetrum that causes hyperaemia, loss of articular cartilage, and softening of the bone. Surgical repair consists of simply excising the impinging fibrous cuff. The outcome of 44 patients treated for TILT over a 6-year period is reviewed. In all cases, TILT repair resulted in improved wrist motion and strength. Ninety-five percent of patients reported a significant improvement in pain both at rest and with activity.
尺腕疼痛是一个复杂的问题，其病因常常难以捉摸。局部三角骨疼痛、腕关节过度屈曲损伤史以及X线片正常，同时伴有尺腕肿胀和腕关节活动受限，这一诊断三联征通常归因于一种我们称为三角骨撞击韧带撕裂（TILT）的综合征。损伤机制导致纤维组织袖套从尺侧吊带机制向远端移位，从而对三角骨造成慢性撞击，引起充血、关节软骨丧失和骨质软化。手术修复只需切除撞击的纤维袖套。本文回顾了6年间44例接受TILT治疗患者的治疗结果。在所有病例中，TILT修复均改善了腕关节的活动度和力量。95%的患者报告静息和活动时疼痛均有显著改善。
