Cardoso Afonso Nobre Pinto, Viegas Rui, Gamelas Patrícia, Falcão Pedro, Baptista Carolina, Silva Filipa Santos
Departamento de Ortopedia e Traumatologia, Hospital Beatriz Ângelo, Loures, Portugal.
Rev Bras Ortop (Sao Paulo). 2020 Oct;55(5):612-619. doi: 10.1055/s-0040-1702959. Epub 2020 Apr 6.
The objective of the present study was to evaluate the clinical and radiographic results of our series regarding ulnar shortening osteotomy, as well as to briefly review the pathology, indications and surgical options of ulnocarpal conflict. We performed a retrospective analysis of consecutive patients who were treated with ulnar shortening osteotomy between January 2012 and June 2017 at our hospital. We clinically evaluated pain, articular range of motion, grip strength and functional outcomes using the quick-DASH questionnaire. We radiographically measured the pre- and postoperative ulnar variance and the shortening performed. We identified eight operated patients, and it was possible to evaluate seven of them. Pain decreased in this population (visual analogue scale [VAS] score changed from 7 to 2.6, < 0.05), there was a decrease in quick-DASH (64 to 28, < 0.05) and we found a decrease in the articular amplitude ∼ 7° for flexion ( = 0.2), and of 5.5° for supination ( = 0.3), as well as decreasing grip strength to about 86% on the contralateral side ( = 0.07). The ulnar variance changed from a mean of + 5.5 mm to - 1.1 mm ( < 0.05). Two out of 8 patients (25%) presented plaque-related symptoms and one of them underwent a new intervention to extract the material. Ulnar shortening osteotomy is an effective surgical procedure both in the treatment of ulnocarpal conflict and in the discharge of the ulna. The results presented agreement with other results published in the literature, with good clinical and radiographic results.
本研究的目的是评估我们这组尺骨短缩截骨术的临床和影像学结果,并简要回顾尺腕撞击的病理、适应症和手术选择。 我们对2012年1月至2017年6月在我院接受尺骨短缩截骨术治疗的连续患者进行了回顾性分析。我们使用快速DASH问卷对疼痛、关节活动范围、握力和功能结果进行了临床评估。我们通过影像学测量了术前和术后的尺骨变异及截骨缩短情况。 我们确定了8例接受手术的患者,其中7例可以进行评估。该组患者的疼痛减轻(视觉模拟量表[VAS]评分从7分降至2.6分,P<0.05),快速DASH评分降低(从64分降至28分,P<0.05),我们发现屈曲时关节活动幅度下降约7°(P=0.2),旋后时下降5.5°(P=0.3),握力下降至对侧的约86%(P=0.07)。尺骨变异从平均+5.5mm变为-1.1mm(P<0.05)。8例患者中有2例(25%)出现与钢板相关的症状,其中1例接受了新的手术取出材料。 尺骨短缩截骨术在治疗尺腕撞击和尺骨卸载方面都是一种有效的手术方法。本研究结果与文献中发表的其他结果一致,临床和影像学结果良好。