Li Yong, Ma Mingming, Ruan Xiaojun, Fu Yongbin
Microsurgical Repair and Reconstruction Ward of Department of Orthopaedics, Fu Yang People's Hospital, Fuyang Anhui, 236000, P. R. China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2025 Jan 15;39(1):59-63. doi: 10.7507/1002-1892.202410090.
To investigate the effectivess of arthroscopic Wafer surgery combined with triangular fibrocartilage complex (TFCC) insertion point reconstruction in the treatment of Palmer type ⅡC combined with typeⅠB ulnar impingement syndrome.
The clinical data of 14 patients with Parlmer type ⅡC combined with type ⅠB ulnar impingement syndrome who met the selection criteria between July 2021 and April 2024 were retrospectively analyzed. There were 7 males and 7 females with an average age of 43 years ranging from 16 to 59 years. The causes of injury were fall in 8 cases and sprain in 6 cases. The time from injury to operation ranged from 1 to 6 months, with an average of 2.3 months. Distal radioulnar joint instability was found in all cases. Arthroscopic Wafer surgery combined with TFCC insertion point reconstruction was used. The effectiveness was evaluated by comparing the wrist flexion-dorsiflexion range of motion, wrist ulnar deviation-radial deflection range of motion, forearm pronation-supination range of motion, visual analogue scale (VAS) score, and modified Mayo wrist score before and after operation.
All patients were followed up 6-12 months, with an average of 9.1 months. The positive variation of ulna was (3.2±0.7) mm before operation, and the negative variation of ulna was (2.2±0.6) mm after operation. There was a significant difference in ulna variation between pre- and post-operation ( =23.851, <0.001). The pain symptoms and forearm rotation function of the patients after operation significantly improved. At last follow-up, the wrist flexion-dorsiflexion range of motion, wrist ulnar deviation-radial deflection range of motion, forearm pronation-supination range of motion, VAS score, and modified Mayo wrist score significantly improved when compared with those before operation ( <0.05).
Arthroscopic Wafer surgery combined with TFCC insertion point reconstruction can effectively relieve wrist pain, enhance the stability of the distal radioulnar joint, and restore the function of the wrist in patients with Palmer type ⅡC combined with type ⅠB ulnar impingement syndrome.
探讨关节镜下Wafer手术联合三角纤维软骨复合体（TFCC）附着点重建治疗帕尔默ⅡC型合并ⅠB型尺骨撞击综合征的疗效。
回顾性分析2021年7月至2024年4月期间14例符合入选标准的帕尔默ⅡC型合并ⅠB型尺骨撞击综合征患者的临床资料。其中男性7例，女性7例，平均年龄43岁，年龄范围为16至59岁。受伤原因：跌倒8例，扭伤6例。受伤至手术时间为1至6个月，平均2.3个月。所有病例均存在下尺桡关节不稳定。采用关节镜下Wafer手术联合TFCC附着点重建。通过比较手术前后腕关节屈伸活动度、腕关节尺偏-桡偏活动度、前臂旋前-旋后活动度、视觉模拟评分（VAS）及改良梅奥腕关节评分来评估疗效。
所有患者均获随访6至12个月，平均9.1个月。术前尺骨正向变异为（3.2±0.7）mm，术后尺骨负向变异为（2.2±0.6）mm。术前与术后尺骨变异有显著差异（ =23.851，<0.001）。患者术后疼痛症状及前臂旋转功能明显改善。末次随访时，与术前相比，腕关节屈伸活动度、腕关节尺偏-桡偏活动度、前臂旋前-旋后活动度、VAS评分及改良梅奥腕关节评分均显著改善（<0.05）。
关节镜下Wafer手术联合TFCC附着点重建可有效缓解帕尔默ⅡC型合并ⅠB型尺骨撞击综合征患者的腕部疼痛，增强下尺桡关节稳定性，恢复腕关节功能。
