Orthopeadic Surgery Department, The First Hospital of China Medical University, Shenyang, China.
Hand Surgery Department, Central Hospital Affiliated to Shenyang Medical College, Shenyang, China.
Int J Surg. 2022 Aug;104:106725. doi: 10.1016/j.ijsu.2022.106725. Epub 2022 Jun 20.
Ulnar shortening osteotomy (USO) is the most common operation to treat ulnar impaction syndrome (UIS). An alternative to USO is the arthroscopic wafer procedure (AWP). Few studies have directly compared USO and AWP in patients with UIS. This study compared ulnar shortening osteotomy (USO) versus arthroscopic wafer procedure (AWP) for UIS treatment.
PubMed, EMBASE, the Cochrane Library, Wanfang, and CNKI were systematically searched for reports published before March 2021. The outcomes included Modified Mayo Wrist Score, Darrow's Criteria, Disability of Arm, Shoulder, and Hand (DASH), grip strength, visual analog scale (VAS) score, and time to resume manual occupation.
Seven studies (133 and 118 patients with USO and AWP, respectively) were included. There were no differences in combined Darrow's Criteria or Modified Mayo Wrist Score, Modified Mayo Wrist Score, Darrow's Criteria, revision rate, DASH score, VAS score, and time to resume manual occupation. Grip strength was better with AWP (SMD = -0.73, 95%CI: -1.36, -0.11, P = 0.022). Differences were seen for ulna positive variation, favoring USO (WMD = -2.75, 95%CI: -5.17, -0.33, P = 0.026).
In the surgical treatment of UIS, AWP might be associated with improved grip strength, while USO seems to show better results in treating pronounced ulna positive variation. Only evidence of moderate quality could be included in this meta-analysis.
尺骨缩短截骨术（USO）是治疗尺骨撞击综合征（UIS）最常见的手术。尺骨缩短截骨术的替代方法是关节镜下薄片术（AWP）。很少有研究直接比较 UIS 患者的 USO 和 AWP。本研究比较了尺骨缩短截骨术（USO）与关节镜下薄片术（AWP）治疗 UIS 的效果。
系统检索了 PubMed、EMBASE、Cochrane 图书馆、万方和中国知网（CNKI）截至 2021 年 3 月前发表的报告。结果包括改良 Mayo 腕关节评分、Darrow 标准、手臂、肩部和手残疾（DASH）评分、握力、视觉模拟评分（VAS）评分和恢复手工职业的时间。
纳入了 7 项研究（USO 和 AWP 分别为 133 例和 118 例）。联合 Darrow 标准或改良 Mayo 腕关节评分、改良 Mayo 腕关节评分、Darrow 标准、翻修率、DASH 评分、VAS 评分和恢复手工职业的时间无差异。AWP 的握力更好（SMD=-0.73，95%CI：-1.36，-0.11，P=0.022）。尺骨正变异有利于 USO（WMD=-2.75，95%CI：-5.17，-0.33，P=0.026）。
在 UIS 的手术治疗中，AWP 可能与改善握力有关，而 USO 似乎在治疗明显的尺骨正变异方面效果更好。本荟萃分析仅纳入了中等质量的证据。
