Williams C S, Jupiter J B
Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston.
Orthopade. 1993 Feb;22(1):36-45.
The ulnocarpal joint plays a critical role in hand and wrist function. It serves as part of forearm rotation as well as part of the carpal kinematics. The joint is comprised of the distal radio-ulnar articulation, triangular fibrocartilage complex, lunate, triquetrum, hamate, and pisiform, and the intra and extracapsular ligamentous and soft tissue constraints. Traumatic disruptions as well as chronic inflammatory conditions are commonplace. In addition to standard radiographs, arthrography, CT scanning, and MRI studies prove useful. Wrist arthroscopy is becoming of increasing importance in this region of the wrist. Ulnar impaction syndrome may occur associated with malunion of distal radius fracture, ulna positive variance, or chronic TFCC tears. Osteotomy of the distal radius or ulnar shortening osteotomy should be considered. Instability of the distal ulna can be treated with tenodesis procedures, hemi-resection arthroplasty, matched ulna resection or the Sauvé-Kapandji procedure.
尺腕关节在手部和腕部功能中起着关键作用。它是前臂旋转以及腕骨运动学的一部分。该关节由远侧桡尺关节、三角纤维软骨复合体、月骨、三角骨、钩骨、豌豆骨以及关节内和关节外的韧带及软组织限制结构组成。创伤性损伤以及慢性炎症情况很常见。除了标准的X线片外，关节造影、CT扫描和MRI检查都很有用。腕关节镜检查在腕部的这个区域正变得越来越重要。尺骨撞击综合征可能与桡骨远端骨折畸形愈合、尺骨正向变异或慢性TFCC撕裂有关。应考虑桡骨远端截骨术或尺骨短缩截骨术。尺骨远端不稳定可通过肌腱固定术、半切除关节成形术、匹配的尺骨切除术或Sauvé-Kapandji手术进行治疗。
