Slade Joseph F, Gillon Thomas J
Hand and Upper Extremity Center and Microvascular Surgery, Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven, CT 06520-8071, USA.
Tech Hand Up Extrem Surg. 2007 Mar;11(1):74-82. doi: 10.1097/bth.0b013e3180337df9.
A new technique for ulna shortening is described. It is a modification of the open-wafer procedure that preserves the distal ulna's articular surface. A 4- to 5-mm chondral-cortical bone block is removed at the distal ulna articular-metaphysis junction. Closing the bone gap results in the osteotomy site proximal to the sigmoid notch. The distal ulna chondral-cortical fragment is secured with 1 or 2 headless compression screws, which permit early motion and results in solid healing. Similar to Feldon's previously described open-wafer procedure, this new technique reduces the ulna carpal load by reducing the distal ulna carpal length at the distal radioulnar joint. This new technique eliminates the exposure of the radiocarpal joint to continuous bleeding from the distal ulna's trabecular bone as seen in Feldon's open-wafer procedure and avoids all the inherent problems associated with plating the ulna for a typical distal ulna osteotomy, such as delayed union and painful hardware.
本文描述了一种新的尺骨短缩技术。它是对保留尺骨远端关节面的开放式薄骨片手术的改良。在尺骨远端关节-干骺端交界处切除4至5毫米的软骨-皮质骨块。闭合骨间隙会使截骨部位位于乙状切迹近端。尺骨远端软骨-皮质碎片用1或2枚无头加压螺钉固定，这允许早期活动并实现牢固愈合。与费尔登之前描述的开放式薄骨片手术类似，这项新技术通过缩短桡尺远侧关节处的尺骨远端腕骨长度来减轻尺骨腕骨负荷。这项新技术避免了费尔登开放式薄骨片手术中出现的桡腕关节暴露于尺骨远端小梁骨持续出血的情况，并且避免了典型的尺骨远端截骨术中与尺骨钢板固定相关的所有固有问题，如骨不连和植入物疼痛。
