Ozcelik Ismail Bulent, Cavit Ali, Yuceturk Aydin
Hand and Upper Extremity Surgery Unit, Yeniyuzyıl University, Gaziosmanpasa Hospital, El Istanbul Hand and Microsurgery Group, Nişantaşı University Faculty of Health Sciences Dean, Istanbul, Turkey.
Istanbul Haydarpasa Numune Training and Research Hospital, Hand and Upper Extremity Surgery Clinic, Istanbul, Turkey.
J Wrist Surg. 2023 Nov 9;13(6):492-499. doi: 10.1055/s-0043-1775819. eCollection 2024 Dec.
This study aimed to present the results of an alternative technique for treating ulnar impaction syndrome, the "reverse wafer procedure," and assess the mid-term clinical outcomes of patients treated with this technique. A retrospective evaluation was conducted on 14 patients who underwent the reverse wafer procedure for ulnar impaction syndrome between 2013 and 2020. The inclusion criteria for the study were persistent ulnar-sided wrist pain, even after a minimum of 3 months of nonoperative treatment, the presence of a chondral lesion on the lunate, and an intact triangular fibrocartilage complex (TFCC) based on arthroscopic evaluation. Postoperative clinical and subjective functional outcomes were assessed using measures such as wrist range of motion (ROM), grip strength, the Turkish version of the quick disabilities of the arm, shoulder, and hand questionnaire (Quick DASH), and pain levels measured on a visual analog scale (VAS) and were compared with preoperative values. Patient satisfaction was also evaluated postoperatively. The mean follow-up period was 42.2 months (range: 24-68 months). Postoperatively, none of the patients experienced any restriction in ROM. Grip measurements significantly increased after the surgery ( = 0.003). Preoperatively, the patients had a grip strength of 41.14 kg (range 28-48 kg), which improved to 44 kg (range 30-52 kg) postoperatively. Postoperative VAS values and QDASH scores significantly decreased compared with the preoperative values ( < 0.001, = 0.001). The mean VAS score decreased from 6.1 (range 4-8) preoperatively to 0.9 (range 0-5) postoperatively. The mean Quick DASH score decreased from 49.44 (range 25-68.3) preoperatively to 10.13 (range 3.3-36) postoperatively. When asked about their satisfaction with the operation, 13 out of 14 patients reported being highly satisfied with the results. The reverse wafer procedure presents an alternative treatment option for ulnar impaction syndrome in cases where the TFCC is intact. The mid-term results of this described technique are promising. However, further comparative studies with longer follow-ups are necessary to support these findings. IV Therapeutic.
本研究旨在介绍一种治疗尺骨撞击综合征的替代技术——“反向骨片手术”的结果，并评估采用该技术治疗的患者的中期临床疗效。
对2013年至2020年间接受反向骨片手术治疗尺骨撞击综合征的14例患者进行了回顾性评估。该研究的纳入标准为：即使经过至少3个月的非手术治疗后，尺侧腕部仍持续疼痛；月骨存在软骨损伤；基于关节镜评估，三角纤维软骨复合体（TFCC）完整。术后临床和主观功能结局采用腕关节活动范围（ROM）、握力、土耳其语版手臂、肩部和手部快速残疾问卷（Quick DASH）以及视觉模拟量表（VAS）测量的疼痛程度等指标进行评估，并与术前值进行比较。术后还对患者满意度进行了评估。
平均随访期为42.2个月（范围：24 - 68个月）。术后，所有患者的ROM均无受限。术后握力测量值显著增加（ = 0.003）。术前患者握力为41.14千克（范围28 - 48千克），术后提高至44千克（范围30 - 52千克）。术后VAS值和QDASH评分与术前值相比显著降低（ < 0.001， = 0.001）。VAS评分均值从术前的6.1（范围4 - 8）降至术后的0.9（范围0 - 5）。Quick DASH评分均值从术前的49.44（范围25 - 68.3）降至术后的10.13（范围3.3 - 36）。当被问及对手术的满意度时，14例患者中有13例报告对结果非常满意。
反向骨片手术为TFCC完整的尺骨撞击综合征病例提供了一种替代治疗选择。所述技术的中期结果很有前景。然而，需要进行更长随访期的进一步比较研究来支持这些发现。
IV治疗性。
