Service de Chirurgie Orthopédique 1, Hôpital Roger Salengro, Rue du Professeur Emile Laine, 59037 Lille cedex, France.
Département de Chirurgie Pédiatrique, Hôpital Jeanne de Flandre, Rue du Professeur Emile Laine, 59037 Lille cedex, France.
Hand Surg Rehabil. 2022 Oct;41(5):589-594. doi: 10.1016/j.hansur.2022.07.005. Epub 2022 Jul 27.
The objective of this study was to evaluate the results of isolated ulnar shaft shortening osteotomy (USSO) in the treatment of idiopathic ulnocarpal impingement syndrome. This was a two-center retrospective study. All patients older than 18 years who underwent isolated USSO for idiopathic ulnocarpal impingement syndrome between 2006 and 2016 were included. The outcome measures were: patient satisfaction, decrease in pain intensity, change in occupation, QuickDASH and PRWE functional scores, secondary palliative surgery suggesting failure of the ulnar shaft shortening osteotomy, and postoperative ulnar variance. The main complications were analyzed. Thirty-one patients were included. Twenty-six (84%) were satisfied with the procedure. At an average follow-up of 62 months, there was no secondary palliative surgery. Mean pain intensity on VAS was 7/10 (range, 2-10) and 1.7/10 (range, 0-6) preoperatively and postoperatively, respectively, for a mean decrease of 5.3 ± 2.6 points; this decrease was statistically significant (p < 0.001). None of the manual workers had to alter their work. Mean postoperative QuickDASH score was 19.6/100 (range, 0-79.55) and mean postoperative PRWE score was 23/100 (range, 1-85). Mean postoperative ulnar variance was -0.5 mm. As for complications, 61% of patients (n = 19/31) had discomfort related to the plate; 9.7% (n = 3/31) had distal radioulnar osteoarthritis; 4% (n = 1/19) had a fracture after hardware removal; 13% (n = 4/31) had non-union. Despite a high rate of complications, the study confirmed the effectiveness, in terms of pain, of isolated USSO in the treatment of idiopathic ulnocarpal impingement syndrome. LEVEL OF EVIDENCE: IV; retrospective cohort.
本研究旨在评估尺骨干缩短截骨术（USSO）治疗特发性尺腕撞击综合征的疗效。这是一项两中心回顾性研究。纳入 2006 年至 2016 年间因特发性尺腕撞击综合征行单纯 USSO 的所有年龄大于 18 岁的患者。评估指标包括：患者满意度、疼痛强度降低、职业变化、QuickDASH 和 PRWE 功能评分、提示尺骨干缩短截骨术失败的辅助姑息性手术以及术后尺骨变异。分析了主要并发症。共纳入 31 例患者。26 例（84%）对手术结果满意。平均随访 62 个月，无辅助姑息性手术。术后 VAS 疼痛评分平均为 7/10（范围 2-10）和 1.7/10（范围 0-6），平均降低 5.3±2.6 分，差异有统计学意义（p＜0.001）。无体力劳动者需要改变工作。术后平均 QuickDASH 评分为 19.6/100（范围 0-79.55），术后平均 PRWE 评分为 23/100（范围 1-85）。术后平均尺骨变异为-0.5mm。并发症方面，61%（n=19/31）的患者有与钢板相关的不适；9.7%（n=31/31）有远端桡尺关节炎；4%（n=1/19）有内固定取出后骨折；13%（n=4/31）有骨不连。尽管并发症发生率较高，但本研究证实了单纯 USSO 治疗特发性尺腕撞击综合征在缓解疼痛方面的有效性。证据水平：IV；回顾性队列研究。
