Ozer Kagan, Zhu Andy F, Siljander Breana, Lawton Jeffrey N, Waljee Jennifer F
Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan.
University of Michigan, School of Medicine, Ann Arbor, Michigan.
J Wrist Surg. 2018 Jul;7(3):247-252. doi: 10.1055/s-0038-1627458. Epub 2018 Feb 12.
Forearm rotation results in change in ulnar variance. Axial loading of the wrist is required to maintain daily activities. Change in ulnar variance during axial loading has not been investigated previously. To measure the change in ulnar variance on axially loaded wrists. We examined 21 asymptomatic individuals and 24 patients with unilateral ulnar-sided wrist pain. All patients underwent standard neutral posteroanterior wrist radiographs without load and under axial loading on bilateral wrists. Axial loading was standardized at 18.1 kgf using an analog weight scale. A magnetic resonance (MR) arthrogram was obtained only in patients with ulnar-sided wrist pain. Beighton flexibility score was recorded on healthy volunteers. Change in ulnar variance between 0 and 18.1 kgf was compared for each wrist among all subjects. A correlation was sought between the change in ulnar variance, MR arthrogram findings, and physical examination. In individuals without wrist pain, on average, 0.4 mm increase in ulnar variance was measured between 0 and 18.1 kgf. There was no difference between the dominant and nondominant side. No correlation was found with increasing age. In contrast, patients with ulnar-sided wrist pain displayed an average increase of 0.8 mm in ulnar variance. Compared with the contralateral wrist, more than 1 mm increase in ulnar variance was correlated with intra-articular pathologies including dorsoulnar ligament disruption, central triangular fibrocartilage complex (TFCC) perforation, and foveal detachment. Compared with contralateral side, more than 1 mm increase in ulnar variance is suggestive of longitudinal instability or TFCC pathology. Level II, diagnostic.
前臂旋转会导致尺骨变异。维持日常活动需要手腕承受轴向负荷。此前尚未研究过轴向负荷过程中尺骨变异的变化情况。
为测量轴向负荷下手腕的尺骨变异变化。
我们检查了21名无症状个体和24名单侧尺侧手腕疼痛的患者。所有患者均接受了双侧手腕在无负荷和轴向负荷下的标准中立位腕关节后前位X线片检查。使用模拟体重秤将轴向负荷标准化为18.1千克力。仅对尺侧手腕疼痛的患者进行了磁共振（MR）关节造影。对健康志愿者记录了贝顿柔韧性评分。比较了所有受试者每只手腕在0至18.1千克力之间的尺骨变异变化。研究了尺骨变异变化、MR关节造影结果和体格检查之间的相关性。
在无手腕疼痛的个体中，平均而言，在0至18.1千克力之间测量到尺骨变异增加了0.4毫米。优势侧和非优势侧之间没有差异。未发现与年龄增长存在相关性。相比之下，尺侧手腕疼痛的患者尺骨变异平均增加了0.8毫米。与对侧手腕相比，尺骨变异增加超过1毫米与关节内病变相关，包括背尺侧韧带断裂、中央三角纤维软骨复合体（TFCC）穿孔和小凹脱离。
与对侧相比，尺骨变异增加超过1毫米提示存在纵向不稳定或TFCC病变。
二级，诊断性研究。
