Colantoni Julie, Chadderdon Christopher, Gaston R Glenn
Carolinas Medical Center, Charlotte, North Carolina, U.S.A.
OrthoCarolina, Charlotte, North Carolina, U.S.A.
Arthrosc Tech. 2014 Jan 24;3(1):e123-5. doi: 10.1016/j.eats.2013.09.008. eCollection 2014 Feb.
Ulnar impaction syndrome is abutment of the ulna on the lunate and triquetrum that increases stress and load, causing ulnar-sided wrist pain. Typically, ulnar-positive or -neutral variance is seen on a posteroanterior radiograph of the wrist. The management of ulnar impaction syndrome varies from conservative, symptomatic treatment to open procedures to shorten the ulna. Arthroscopic management has become increasingly popular for management of ulnar impaction with ulnar-positive variance of less than 3 mm and concomitant central triangular fibrocartilage complex tears. This method avoids complications associated with open procedures, such as nonunion and symptomatic hardware. The arthroscopic wafer procedure involves debridement of the central triangular fibrocartilage complex tear, along with debridement of the distal pole of the ulna causing the impaction. Debridement of the ulna arthroscopically is taken down to a level at which the patient is ulnar neutral or slightly ulnar negative. Previous studies have shown good results with relief of patient symptoms while avoiding complications seen with open procedures.
尺骨撞击综合征是指尺骨与月骨和三角骨相抵，增加应力和负荷，导致尺侧腕部疼痛。通常，在腕关节后前位X线片上可见尺骨正向或中性变异。尺骨撞击综合征的治疗方法多样，从保守的对症治疗到缩短尺骨的开放性手术。对于尺骨正向变异小于3mm且伴有中央三角纤维软骨复合体撕裂的尺骨撞击综合征，关节镜治疗越来越受欢迎。这种方法避免了与开放性手术相关的并发症，如不愈合和植入物相关症状。关节镜下植骨手术包括清理中央三角纤维软骨复合体撕裂，以及清理导致撞击的尺骨远端。关节镜下对尺骨进行清理，直至患者尺骨呈中性或略呈尺骨负向。先前的研究表明，该方法在缓解患者症状方面效果良好，同时避免了开放性手术所见的并发症。
