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一名冰球运动员尺侧腕伸肌腱复发性脱位合并尺侧三角纤维软骨复合体损伤:病例报告

Recurrent Dislocation of the Extensor Carpi Ulnaris Tendon with Ulnar-Sided Triangular Fibrocartilage Complex Injury in an Ice Hockey Player: A Case Report.

作者信息

Tomori Yuji, Nanno Mitsuhiko, Takai Shinro

机构信息

Department of Orthopedic Surgery, Nippon Medical School Musashi Kosugi Hospital.

Department of Orthopedic Surgery, Nippon Medical School Hospital.

出版信息

J Nippon Med Sch. 2020 Sep 9;87(4):233-239. doi: 10.1272/jnms.JNMS.2020_87-410. Epub 2020 Apr 30.

Abstract

Ulnar-sided wrist pain is common among athletes who subject their wrists to forceful rotational movements. Injury to the numerous complex structures in the ulnar wrist, including the extensor carpi ulnaris (ECU) tendon and triangular fibrocartilage complex (TFCC), can result in ulnar-sided wrist pain. Although differentiating between ECU tendinitis and TFCC injury is necessary, ECU tendon disorders and TFCC injury occasionally occur concurrently. Subluxation or dislocation of the ECU tendon is rare but may cause symptoms in athletes subjecting their wrists to forceful rotational movements. We present a case of recurrent dislocation of the ECU tendon and ulnar-sided TFCC injury in a 21-year-old male university-league ice hockey player. He initially underwent ECU stabilization; however, his ulnar wrist pain persisted, which adversely affected his athletic performance. He underwent additional surgery to repair the TFCC, which led to definitive resolution of his symptoms and resulted in his return to competitive performance 3 months postoperatively. Treatment of symptomatic dislocation of the ECU remains controversial. In our patient, recurrent dislocation of the ECU tendon with concurrent ulnar-sided TFCC injury resulted in ulnar-sided wrist pain. Combined reconstruction of the tendon's subsheath, using the extensor retinaculum, and repair of the TFCC injury was required for full recovery of his athletic performance.

摘要

尺侧腕部疼痛在那些手腕承受强力旋转运动的运动员中很常见。尺侧腕部众多复杂结构的损伤,包括尺侧腕伸肌(ECU)肌腱和三角纤维软骨复合体(TFCC),可导致尺侧腕部疼痛。虽然区分ECU肌腱炎和TFCC损伤很有必要,但ECU肌腱疾病和TFCC损伤偶尔会同时发生。ECU肌腱半脱位或脱位很少见,但可能在手腕承受强力旋转运动的运动员中引起症状。我们报告一例21岁男性大学联赛冰球运动员的ECU肌腱复发性脱位和尺侧TFCC损伤病例。他最初接受了ECU稳定手术;然而,他的尺侧腕部疼痛持续存在,这对他的运动表现产生了不利影响。他接受了额外的手术来修复TFCC,这使他的症状得到了彻底缓解,并在术后3个月恢复了竞技表现。ECU有症状性脱位的治疗仍存在争议。在我们的患者中,ECU肌腱复发性脱位合并尺侧TFCC损伤导致了尺侧腕部疼痛。为了使他的运动表现完全恢复,需要使用伸肌支持带对肌腱鞘进行联合重建,并修复TFCC损伤。

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