Topper S M, Wood M B, Ruby L K
Department of Orthopaedic Surgery, University of Colorado Health Science Center, Colorado Springs, USA.
J Hand Surg Am. 1997 Jul;22(4):699-704. doi: 10.1016/S0363-5023(97)80131-1.
A series of 8 patients each with an excessively long ulnar styloid that was impacting the triquetrum, causing chondromalacia, synovitis, and pain, is presented. Four patients developed symptoms as a result of an injury and 4 had no definable acute precipitating injury. The average age at the time of surgery was 34 years. There were 3 male and 5 female patients. The average follow-up period was 34 months. All patients were treated by open partial ulnar styloidectomy. Outcome was evaluated clinically and by means of patient questionnaire and radiographs. Pain decreased from a preoperative average score of 3.5 to a postoperative average score of 1.3, which equates to mild pain requiring no medication. All but 1 patient returned to their previous employment unrestricted. The average preoperative ulnar styloid length was 7.4 mm and the average ulnar styloid process index was 0.41, which is almost twice normal. There were no complications. It is likely that an excessively long ulnar styloid has important implications for the kinematics of the lunatotriquetral interval. Details of the diagnosis of this condition, including a new provocative test, and operative management are discussed.
本文报告了一系列8例患者，他们均存在尺骨茎突过长的情况，尺骨茎突过长压迫三角骨，导致软骨软化、滑膜炎和疼痛。其中4例患者因受伤出现症状，4例患者无明确的急性诱发损伤。手术时的平均年龄为34岁。男性患者3例，女性患者5例。平均随访时间为34个月。所有患者均接受了开放性部分尺骨茎突切除术。通过临床评估、患者问卷和X线片对结果进行评价。疼痛程度从术前平均评分3.5降至术后平均评分1.3，这相当于轻度疼痛，无需药物治疗。除1例患者外，所有患者均恢复了之前的工作，且不受限制。术前尺骨茎突平均长度为7.4 mm，尺骨茎突指数平均为0.41，几乎是正常水平的两倍。无并发症发生。尺骨茎突过长可能对月三角间隙的运动学有重要影响。本文讨论了该疾病的诊断细节，包括一种新的激发试验以及手术治疗方法。
