Department of Orthopedic Surgery, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan.
J Hand Surg Asian Pac Vol. 2022 Jun;27(3):491-498. doi: 10.1142/S2424835522500497. Epub 2022 May 27.
Positive ulnar variance (UV) may be associated with a higher incidence of ulnar impaction syndrome (UIS). However, neutral and/or negative UV has also been associated with the development of UIS; therefore, other risk factors may be involved. The purpose of this study was to compare radiological bone morphology in patients with UIS and asymptomatic controls. Between 2009 and 2018, posteroanterior wrist radiographs of 47 wrists in 45 patients diagnosed with UIS were compared with those of 163 wrists in 93 asymptomatic patients from the control group. The following parameters were obtained: ulnar variance (UV); ulnar head top-fovea distance (UTFD); capitate-triquetrum distance (CTD); radio-lunate distance (RLD) and lunate coverage ratio (LCR). The morphology of the lunate was classified based on the absence (type I) or presence (type II) of a medial facet that articulates with the hamate. The radiographic parameters and lunate types were compared between the two groups. We then divided the groups into two subgroups: the positive UV subgroup and the neutral/negative UV subgroup. In each subgroup, the radiographic parameters and lunate types were compared between the UIS and control groups. In the UIS group, the UV and UTFD were significantly increased compared to those in the control group. The proportion of type II lunates was significantly higher in the UIS group than in the control group. In addition, the type II lunate was more common in the UIS group in both the positive UV and negative UV groups. Our study suggests that in addition to positive UV, ulnar head morphology with an increased UTFD and type II lunate morphology may be associated with the development of ulnar impaction syndrome. Level III (Diagnostic).
正的尺侧偏距（UV）可能与较高的尺骨撞击综合征（UIS）发生率相关。然而，中立和/或负的 UV 也与 UIS 的发展相关；因此，可能涉及其他危险因素。本研究的目的是比较 UIS 患者和无症状对照组的放射学骨形态。在 2009 年至 2018 年间，比较了 45 例 UIS 患者的 47 个腕关节和 93 例无症状对照组的 163 个腕关节的前后位腕关节 X 线片。获得了以下参数：尺侧偏距（UV）；尺骨头顶窝距离（UTFD）；头状骨-三角骨距离（CTD）；桡骨-月骨距离（RLD）和月骨覆盖率（LCR）。根据与舟骨相接的内侧关节面的存在（I 型）或不存在（II 型）对月骨形态进行分类。比较了两组之间的影像学参数和月骨类型。然后将两组分为正 UV 亚组和中和/负 UV 亚组。在每个亚组中，比较 UIS 组和对照组之间的影像学参数和月骨类型。在 UIS 组中，UV 和 UTFD 明显大于对照组。UIS 组中 II 型月骨的比例明显高于对照组。此外，在正 UV 和负 UV 组中，UIS 组的 II 型月骨更常见。本研究表明，除了正的 UV 外，尺骨头增大的 UTFD 和 II 型月骨形态也可能与尺骨撞击综合征的发生有关。III 级（诊断）。
