Clinical Efficacy Of Ulnar Styloid Intra-articular Osteotomy On Ulnar Impaction Syndrome

Objective To observe and compare the clinical efficacy of ulnar styloid intra-articular osteotomy and ulnar shaft transverse osteotomy in the treatment of ulnar impaction syndrome,so as to provide some clinical reference for the treatment of ulnar impaction syndrome.Methods Retrospectively analyzed 52 patients with ulnar impaction syndrome(53 with wrist joint disease,including 1 with double wrists disease)admitted to Tangshan People’s Hospital Affiliated to North China University of Science and Technology from January 2015 to November 2017 according to the criteria established in this experiment,and divided them into control group(group A)with 28 patients,28 wrist diseases and experimental group(group B)with 24 patients,25 wrist diseases according to the operation methods.The control group was treated with ulnar shaft transverse osteotomy,while the experimental group was treated with ulnar styloid intra-articular osteotomy.Compared the general condition,fracture healing time,operation time and Cooney score of postoperative wrist function between the two groups;compared the height of ulna,wrist mobility,DASH score of upper limb function and visual analogue score(VAS)between the two groups before and after operation,and evaluated the changes of carpal cystic changes in postoperative imaging.Results All patients were followed up for 1-1.5 years,with an average of 1.2 years,and the wound healing was satisfactory without infection or abnormal sensation.(1)There was no significant difference in general clinical data such as age,gender and wrist between the two groups(P > 0.05).(2)Compared with the ulna height before operation,the ulna height after operation was shorter in both groups,the difference was statistically significant(P < 0.05),and there was no significant difference in the ulna height before and after operation between the two groups(P > 0.05).(3)There was no significant difference in VAS score between the two groups before operation,3 months after operation and 1 year after operation(P > 0.05);and compared with the VAS score before operation,the VAS score of the two groups was lower at 3 months and 1 year after operation,and the difference was statistically significant(P < 0.05).(4)Compared with the DASH score before operation,the DASH score in the two groups at 1 year after operation was lower,and the difference was statistically significant(P < 0.05);and there was no significant difference in DASH score before operation and 1 year after operation between the two groups(P > 0.05);as well as no significant difference in Cooney score between the two groups at 1 year after operation(P > 0.05).(5)Compared with group A,the operation time and fracture healing time in group B were shorter,and the difference was statistically significant(P < 0.05).(6)Compared with the wrist mobility before operation,the wrist motion range of the two groups was larger in one year after operation,and the difference was statistically significant(P < 0.05);there was no significant difference in wrist motion between the two groups before operation and one year after operation(P > 0.05).(7)In 18 patients with carpal cystic degeneration,the cystic degeneration showed improvement during the wrist joint X-ray examination one year after operation;in 8 patients,the cystic degeneration of lunate bone disappeared;and in 2 patients,the cystic degeneration of triquetral bone disappeared;although the cystic degeneration in the remaining patients did not completely disappear,however,the scope of the lesion was reduced to varying degrees,and the vesicle wall was blurred.Conclusion Ulnar styloid intra-articular osteotomy and ulnar shaft transverse osteotomy have similar clinical effects in the treatment of ulnar impaction syndrome,both of them can alleviate ulnar wrist pain,improve wrist function,correct ulna height and reverse the imaging manifestations of carpal cystic degeneration.However,compared with ulnar shaft transverse osteotomy,ulnar styloid intra-articular osteotomy has shorter operation time and shorter fracture healing time,it can also repair triangular fibrocartilage complex while correcting the ulna height.Therefore,it is a simple and safe surgical method for the treatment of ulna impaction syndrome,which is worthy of clinical promotion.Figure 6;Table 8;Reference 100...