Center for Hand, Elbow and Sports Medicine, Izumi Orthopaedic Hospital, Sendai, Japan.
J Hand Surg Asian Pac Vol. 2020 Dec;25(4):474-480. doi: 10.1142/S2424835520500538.
The purpose of this study was to report the results of metaphyseal and diaphyseal ulnar shortening osteotomies (USO) for the treatment of ulnar abutment syndrome (UAS). From 2011 to 2016, we performed metaphyseal USO in 8 patients (8 wrists) and diaphyseal USO in 6 patients (7 wrists). The results were investigated in terms of bone union and cast immobilization, wrist and forearm range of motion (ROM). The mean follow-up duration was 29 months. All 14 patients had bone union. The mean duration of bone union in metaphyseal USO and diaphyseal USO were 3.5 months and 4.3 months and the duration of cast immobilization after surgery were 24.2 days and 29.2 days. The mean forearm ROM (degree) were 134.3 (pronation/supination: 66.7/67.6) and 169.3 (pronation/supination: 84.3/85.0) at 3 months after surgery and 173.4 (pronation/supination: 86.0/87.4) and 172.8 (pronation/supination: 87.1/85.7) at 6 months after surgery. The results from this study suggest that metaphyseal osteotomies are an effective alternative to diaphyseal osteotomies for the treatment of ulnar abutment syndrome. Although metaphyseal osteotomies were associated with temporary decrease of pronation, this discrepancy resolved at 6 months postoperatively. Metaphyseal USO has the potential to promote primary bone union and appears to be an alternative treatment for UAS.
本研究旨在报告治疗尺骨撞击综合征（UAS）的干骺端和骨干尺骨缩短截骨术（USO）的结果。2011 年至 2016 年，我们对 8 例患者（8 腕）进行了干骺端 USO，对 6 例患者（7 腕）进行了骨干 USO。根据骨愈合和石膏固定、腕关节和前臂活动范围（ROM）评估结果。平均随访时间为 29 个月。所有 14 例患者均获得骨愈合。干骺端 USO 和骨干 USO 的平均骨愈合时间分别为 3.5 个月和 4.3 个月，术后石膏固定时间分别为 24.2 天和 29.2 天。术后 3 个月时，平均前臂 ROM（度）分别为 134.3（旋前/旋后：66.7/67.6）和 169.3（旋前/旋后：84.3/85.0），术后 6 个月时，平均前臂 ROM（度）分别为 173.4（旋前/旋后：86.0/87.4）和 172.8（旋前/旋后：87.1/85.7）。本研究结果表明，干骺端截骨术是治疗尺骨撞击综合征的有效方法，可替代骨干截骨术。虽然干骺端截骨术与旋前的暂时性减少有关，但这种差异在术后 6 个月时得到解决。干骺端 USO 具有促进骨愈合的潜力，似乎是 UAS 的一种替代治疗方法。
