Hauck R M, Skahen J, Palmer A K
Department of Surgery, Pennsylvania State University College of Medicine, Hershey, USA.
J Hand Surg Am. 1996 May;21(3):418-22. doi: 10.1016/S0363-5023(96)80355-8.
Symptomatic nonunion of the ulnar styloid is an uncommon problem that is usually best treated by simple excision of the ulnar styloid fragment. Two types of nonunion of the ulnar styloid are described here on an anatomic basis, and their treatment differs. Type 1 is defined as a nonunion associated with a stable distal radioulnar joint. Type 2 is defined as a nonunion associated with subluxation of the distal radioulnar joint. The postoperative follow-up period for the two types ranged from 4 months to 13 years, with a mean of 5 years 2 months. Eleven type 1 wrists were treated with excision of the fragment, and all patients had satisfactory relief of pain. Nine type 2 wrists required restoration of the anatomy of the traingular fibrocartilage complex. Three of these had large fragments that were treated by open reduction and internal fixation. All three patients were completely relieved of their discomfort. Six other patients underwent excision of the fragment and repair of the triangular fibrocartilage complex to the distal ulna. This group had four excellent, one good, and one fair result. If the distal radioulnar joint is stable on presentation or if its stability is restored, then long-term relief of pain from ulnar styloid nonunion is achieved by treatment of the nonunion.
尺骨茎突有症状的骨不连是一个不常见的问题，通常通过简单切除尺骨茎突碎片来进行最佳治疗。本文基于解剖学描述了两种类型的尺骨茎突骨不连，其治疗方法有所不同。1型定义为与稳定的下尺桡关节相关的骨不连。2型定义为与下尺桡关节半脱位相关的骨不连。这两种类型的术后随访期为4个月至13年，平均为5年2个月。11例1型腕关节采用碎片切除治疗，所有患者疼痛均得到满意缓解。9例2型腕关节需要恢复三角纤维软骨复合体的解剖结构。其中3例有大的碎片，采用切开复位内固定治疗。所有3例患者的不适均完全缓解。另外6例患者接受了碎片切除和三角纤维软骨复合体向尺骨远端的修复。该组有4例优、1例良和1例可的结果。如果下尺桡关节在就诊时稳定或其稳定性得以恢复，那么通过治疗骨不连可实现尺骨茎突骨不连疼痛的长期缓解。
