Declerq Jonas, Vanhove Wim, Benis Szabolcs, Hollevoet Nadine
Acta Orthop Belg. 2019 Dec;85(4):464-471.
The aim of the study was to find out if ulnar shortening is effective to treat ulnar wrist pain and which factors influence outcome. Thirty-seven patients were evalua- ted with a mean follow-up of 4.5 years. Thirty patients (81%) would undergo the same operation again although 21 (57%) had residual ulnar wrist pain. Mean disabilities of arm, shoulder and hand (DASH) score was 22 and mean patient rated wrist evaluation score (PRWE) was 33. DASH and PRWE scores were better in smokers, in patients operated on the non- dominant side and when follow-up was longer. PRWE score was worse in posttraumatic cases. Age, gender and type of osteotomy did not influence outcome. Three patients (8%) needed an additional operation for nonunion and in 17 (46%) plate and screws had to be removed. It can be concluded that ulnar shortening can be proposed to treat ulnocarpal wrist pain, but complete pain relief cannot be guaranteed and additional surgery may be required.
本研究的目的是确定尺骨短缩术治疗尺骨腕关节疼痛是否有效以及哪些因素会影响治疗结果。对37例患者进行了评估,平均随访4.5年。30例患者(81%)表示愿意再次接受相同手术,尽管其中21例(57%)仍有尺骨腕关节疼痛残留。手臂、肩部和手部功能障碍(DASH)平均评分为22分,患者自评腕关节评估(PRWE)平均评分为33分。吸烟者、非优势侧接受手术的患者以及随访时间较长者的DASH和PRWE评分较好。创伤后病例的PRWE评分较差。年龄、性别和截骨类型不影响治疗结果。3例患者(8%)因骨不连需要再次手术,17例患者(46%)需要取出钢板和螺钉。可以得出结论,尺骨短缩术可用于治疗尺腕关节疼痛,但不能保证完全缓解疼痛,可能需要额外的手术。