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创伤性腕骨尺侧移位:早期识别与治疗

Traumatic ulnar translocation of the carpus: early recognition and treatment.

作者信息

Berschback J C, Kalainov D M, Husain S N, Wiedrich T A, Cohen M S, Nagle D J

机构信息

Department of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.

出版信息

J Hand Surg Eur Vol. 2012 Oct;37(8):755-64. doi: 10.1177/1753193412436626. Epub 2012 Feb 22.

Abstract

This study evaluated the clinical outcomes and radiographic features of surgically treated traumatic ulnocarpal translocation in nine patients (ten cases). All ligament and fracture repairs were completed within 2 months of injury. Seven cases were examined at a mean of 6.5 years, and information in three cases was obtained from medical records at a mean of 13 months after injury. At final evaluation, the mean disabilities of the arm, shoulder, and hand score was 6 (range, 0-16), and the mean Mayo modified wrist score was 76 (range, 40-100). Ulnocarpal translocation was evident in nine of the injured wrists, six of which showed arthritis, and in four of the uninjured wrists. Ulnar variance measured negative in nine cases and neutral in one case. Pre-existing medial alignment of the carpus and ulnar minus variance may predispose to traumatic ulnocarpal translocation. Early injury repair does not assure restoration of radiocarpal alignment or prevent joint deterioration; however, these changes do not always portend a suboptimal result.

摘要

本研究评估了9例(10侧)手术治疗创伤性尺腕关节脱位的临床结果和影像学特征。所有韧带和骨折修复均在受伤后2个月内完成。7例患者平均在受伤6.5年后接受检查,3例患者的信息来自受伤后平均13个月的病历。在最终评估时,手臂、肩部和手部功能障碍评分的平均值为6分(范围为0 - 16分),Mayo改良腕关节评分的平均值为76分(范围为40 - 100分)。9例受伤腕关节中可见尺腕关节脱位,其中6例出现关节炎,4例未受伤腕关节中也有此情况。尺骨变异在9例中为负值,1例为中性。腕骨先前存在的内侧对线和尺骨负变异可能易导致创伤性尺腕关节脱位。早期损伤修复不能确保桡腕关节对线恢复或防止关节退变;然而,这些改变并不总是预示着结果不理想。

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