Isaacs Jonathan, Howard Susan B, Gulkin Daniel
Hand (N Y). 2010 Jun;5(2):148-54. doi: 10.1007/s11552-009-9226-3. Epub 2009 Sep 22.
Extra-articular ulna shortening osteotomy, in principle, is an accepted treatment option for symptomatic degenerative and traumatic triangular fibrocartilage complex (TFCC) tears. Despite the benefits of this surgical approach, potential disadvantages include risk of nonunion, soft tissue irritation, and the need for future hardware removal. A recently introduced low profile ulna shortening system was designed to decrease these potential complications. A single-surgeon prospective study was performed to evaluate this system. Ten consecutive patients undergoing ulna shortening for ulnar-sided wrist pain compatible with TFCC pathology participated in the study. Subjective, objective, and radiographic assessments were performed preoperatively and up to 24 weeks postoperatively. Based on visual analog scale (VOS) ratings (0 to 10), pain scores significantly improved (p < 0.05) and average patient satisfaction was 8.7. DASH and PRWE scores improved at three month follow-up (p < 0.05). Osteotomy healing time averaged 10.3 weeks, and there were no nonunions. Average discomfort associated with palpation of the plate at final follow-up was 3.3 (using VOS), and one patient requested removal of the hardware. In this short-term follow-up study, the assessed ulna shortening system appears effective and, in general, well tolerated.
原则上，关节外尺骨短缩截骨术是治疗有症状的退行性和创伤性三角纤维软骨复合体（TFCC）撕裂的一种公认的治疗选择。尽管这种手术方法有诸多益处，但其潜在缺点包括骨不连风险、软组织刺激以及未来需要取出内固定装置。最近推出的一种低轮廓尺骨短缩系统旨在减少这些潜在并发症。开展了一项单术者前瞻性研究以评估该系统。十名因尺侧腕痛且符合TFCC病理改变而接受尺骨短缩手术的连续患者参与了该研究。术前及术后长达24周进行主观、客观和影像学评估。根据视觉模拟量表（VAS）评分（0至10分），疼痛评分显著改善（p < 0.05），患者平均满意度为8.7。在三个月随访时，DASH和PRWE评分改善（p < 0.05）。截骨愈合时间平均为10.3周，未发生骨不连。末次随访时触诊钢板的平均不适评分为3.3（使用VAS），一名患者要求取出内固定装置。在这项短期随访研究中，所评估的尺骨短缩系统似乎有效，且总体耐受性良好。
