PDF(Pubmed)
Abstract：
Purpose Management of ulnar-sided wrist pain is difficult due to the complexity of the anatomy and the similarity of the signs and symptoms of possible diagnoses. The study\'s main purpose is to examine the effect of arthroscopic triangular fibrocartilage (TFC) repair on untreated extensor carpi ulnaris (ECU) tendinitis and synovitis. Methods Thirteen patients who underwent arthroscopic TFC repair in our clinic and preoperatively demonstrated ECU tendon pathology with magnetic resonance imaging (MRI) were included in the retrospective study. Pre- and postoperative visual analog scale (VAS), pre- and postoperative tendinitis and synovitis, postoperative Mayo and patient-rated wrist evaluation score, postoperative grip strength of the operated and control sides, short and long diameters of the ECU tendon in ultrasonography were recorded. Results The mean age of 13 patients (9 females and 4 males) was 39.54 ± 13.54, and the mean follow-up period was 26 ± 7.25 months. While there was no significant difference between pre- and postoperative tendinitis or synovitis levels, VAS decreased significantly (8.46 ± 1.33 vs. 3.00 ± 2.31, p = 0.0016). While the grip strength was 21.78 ± 7.83 on the control side, it was 18.28 ± 7.51 on the surgery side, being significantly lower ( p = 0.0252). Ulnar variance did not affect tendinitis or synovitis. Short and long diameters of ECU were similar for the operated and control sides. While the short diameter did not affect the synovitis-tendinitis score, the bigger the long diameter, the higher the synovitis score (rho = 0.5162). Conclusion In the presence of ECU, tendon pathologies accompanying TFC lesions, additional surgical interventions are mandatory as arthroscopic TFC repair has no significant effect on the healing of ECU. Level of evidence : 4.
摘要：
目的由于解剖结构的复杂性以及可能诊断的体征和症状的相似性，尺侧腕关节疼痛的治疗很困难。该研究的主要目的是检查关节镜下三角纤维软骨（TFC）修复对未经治疗的尺侧伸肌（ECU）肌腱炎和滑膜炎的影响。方法回顾性研究13例在我院接受关节镜下TFC修复术的患者，术前经磁共振成像（MRI）证实有ECU肌腱病理。术前术后视觉模拟量表(VAS),术前和术后肌腱炎和滑膜炎，术后Mayo和患者评估腕部评分，手术和控制侧的术后握力，记录超声检查中ECU肌腱的短径和长径。结果13例患者（女9例，男4例）平均年龄为39.54±13.54，平均随访时间为26±7.25个月。虽然术前和术后肌腱炎或滑膜炎水平之间没有显着差异，VAS显著下降(8.46±1.33vs.3.00±2.31，p=0.0016）。而控制侧的握力为21.78±7.83，手术侧是18.28±7.51，显着降低（p=0.0252）。尺骨变异不影响肌腱炎或滑膜炎。ECU的短直径和长直径对于操作侧和控制侧是相似的。虽然短直径不影响滑膜炎-肌腱炎评分，长直径越大，滑膜炎评分越高(rho=0.5162)。结论在ECU存在的情况下,伴有TFC病变的肌腱病理学，额外的手术干预是强制性的，因为关节镜下TFC修复对ECU的愈合没有显著影响。证据等级：4。
