背景:在一些研究中已经报道了前臂旋光的急性阻塞。它是由腕关节松弛的身体引起的,尺侧腕伸肌肌腱插入,和远端桡尺关节(DRUJ)损伤,包括前臂骨骨折.一些研究报道了由三角纤维软骨复合体(TFCC)撕裂引起的DRUJ损伤的病例。我们报告了一例轻微创伤后前臂旋后急性阻塞的病例,并建议当患者抱怨前臂旋后阻塞时可能发生TFCC撕裂。此外,我们将我们的病例与其他病因学报告进行了比较,磁共振成像(MRI)发现,和关节镜检查结果,并展示我们案例的具体特征。
方法:一名22岁男性主诉左手腕疼痛。他在锻炼中将左手推到地板上之前两个月受伤。体格检查显示,与右侧相比,左手腕的活动范围(ROM)的相对限制为屈曲约10°,伸展约15°。患者还抱怨旋后受限和旋后期间掌侧腕部疼痛。患者在轴向压缩试验中显示压痛。
方法:平片显示无异常。MRI显示中央部分有TFCC撕裂。将撕裂的TFCC皮瓣插入DRUJ的掌侧。
方法:进行左腕关节关节镜手术。关节镜检查显示径向侧的TFCC撕裂。在DRUJ的掌侧插入撕裂的皮瓣。我们使用关节镜抓紧器从DRUJ中取出皮瓣,并将其部分切除。
结果:术中试验显示没有锁定,前臂完全仰卧。手术后两个月,患者没有疼痛,前臂全旋后。
结论:当轻微创伤后发生前臂旋后急性阻塞时,应怀疑TFCC撕裂导致的DRUJ阻塞。MRI有助于诊断;然而,我们建议通过关节镜检查确诊。症状可以通过关节镜手术治疗来解决。
BACKGROUND: Acute blockage of forearm supination has been reported in several studies. It is caused by loose bodies in the wrist joint, extensor carpi ulnaris tendon interposition, and distal radioulnar joint (DRUJ) injuries, including forearm bone fractures. Some studies have reported cases of DRUJ injuries caused by triangular fibrocartilage complex (TFCC) tears.We report a
case of acute blockage of forearm supination after minor trauma and suggest a possible TFCC tear when a patient complains of forearm supination blocking. In addition, we present a comparison between our
case and other
reports on etiology, magnetic resonance imaging (MRI) findings, and arthroscopic findings, and show the specific characteristics of our
case.
METHODS: A 22-year-old male presented with left wrist pain as the chief complaint. He was injured 2 months prior to pushing his left hand on the floor during exercise. Physical examination showed a relative limitation of range of motion (ROM) in the left wrist of about 10° in flexion and about 15° in extension compared with the right side. The patient also complained of supination limitation and volar side wrist pain during supination. The patient showed tenderness in the axial compression test.
METHODS: Plain radiographs showing no abnormalities. MRI showed a TFCC tear in the central portion. A torn flap of the TFCC was interposed on the volar side of the DRUJ.
METHODS: Arthroscopic surgery of the left wrist joint was performed. Arthroscopic examination revealed a tear in the TFCC on the radial side. A torn flap was interposed on the volar side of the DRUJ. We removed the flap from the DRUJ using an arthroscopic grasper and partially resected it.
RESULTS: Intraoperative tests showed no locking and the forearm was well supinated. Two months after the surgery, the patient had no pain and showed full forearm supination.
CONCLUSIONS: DRUJ blocking due to a TFCC tear should be suspected when acute blockage of forearm supination occurs after minor trauma. MRI is helpful for diagnosis; however, we suggest that the diagnosis should be confirmed through arthroscopy. Symptoms can be resolved by surgical treatment using arthroscopy.