Arthroscopic treatment of ulnar impaction syndrome
10.3760/cma.j.issn.0253-2352.2016.15.005
- VernacularTitle:尺骨撞击综合征的关节镜治疗
- Author:
Bo ZHU
;
Li ZHAO
;
Jinyan ZHAO
- Publication Type:Journal Article
- Keywords:
Arthroscopy;
Ulna;
Joint diseases
- From:
Chinese Journal of Orthopaedics
2016;36(15):980-987
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate ulnar impaction syndrome imaging characteristics and wrist arthroscopy in the diagnosis and treatment effects.Methods From September 2006 to April 2014,41 patients with ulnar impaction syndrome were treated.Of all 41 patients,28 were male and 13 female with an average age of 34.5±3.9 years old (ranging from 15 to 52 years old).The preoperative values of wrist range of motion (ROM) were 44.17°±6.22° at volar flexion,42.72°±3.37° at dorsal extension,17.45°±4.11° at radial deviation,19.12°±3.70° at ulnar deviation,66.81°±4.28° at pronation,and 70.27°±5.30° at supination.Arthroscopic exploration was conducted in all patients,aiming to observe the ulnar variance,wrist osteonecrosis,articular cartilage damage and triangular fibrocartilage complex tear.Arthroscopic synovectomy were performed in all cases;33 cases of articular cartilage injury were treated with arthroscopic chondroplasty;16 cases of osteonecrosis were treated with arthroscopic drilling decompression;30 cases with tear of TFC were treated with arthroscopic repair;26 cases with ulna positive mutation were treated with arthroscopic distal ulna resection.Patients were followed at 3,6,and 12 months after operation.At 12 months follow-up,the values of wrist range of motion was evaluated for volar flexion,dorsal extension,radial deviation,ulnar deviation,pronation,and supination.GreenO'Brien method was used to evaluate the function of wrist joint.Results Primary healing was presented in all patients without neurovascular injury and joint infection.All patients were followed up 12-36 months (mean,17.5 months).At 12 months followup,the values of ROM compared with that preoperative increased with significant difference,49.13° ±3.47° at volar flexion,47.13°±2.39° at dorsal extension,19.33°±3.29° at radial deviation,25.17°±4.89° at ulnar deviation,75.73°±7.66° at pronation,and 77.22°±4.89° at supination.According to Green-O'Brien standard,the results were excellent in 21 case,good in 17 cases and fair in 3 case,with 93％ excellent and good rate.Conclusion Wrist arthroscopy dose not only contribute to the diagnosis in ulnar impingement syndrome but also can be used in treating inflammatory synovium and cartilage lesions,bone drilling decompression,TFC repair and arthroscopic distal ulna resection with improvement in the range of motion of the wrist joint and function.
