关节镜下三角纤维软骨修复对尺方腕伸肌腱炎和滑膜炎合并三角纤维软骨撕裂的影响

Pub Date : 2023-10-09 DOI:10.1055/s-0043-1775802
Uğur Bezirgan, Yener Yoğun, Bedir Özgencil, Merve Dursun Savran, Aysun Genç, Mehmet Armangil
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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. 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引用次数: 0

摘要

摘要目的尺侧腕关节疼痛由于其解剖结构的复杂性以及可能诊断的体征和症状的相似性,治疗难度较大。本研究的主要目的是探讨关节镜下三角形纤维软骨(TFC)修复对未治疗的尺侧腕伸肌(ECU)肌腱炎和滑膜炎的影响。方法回顾性分析我院收治的13例关节镜下TFC修复术患者,术前经磁共振成像(MRI)检查发现ECU肌腱病变。记录术前和术后视觉模拟评分(VAS)、术前和术后肌腱炎和滑膜炎、术后Mayo评分和患者评定的腕关节评价评分、术后手术侧和控制侧握力、超声检查ECU肌腱短径和长径。结果13例患者(女9例,男4例)平均年龄39.54±13.54岁,平均随访时间26±7.25个月。虽然术前和术后肌腱炎或滑膜炎水平无显著差异,但VAS明显降低(8.46±1.33比3.00±2.31,p = 0.0016)。对照组握力为21.78±7.83,手术组握力为18.28±7.51,差异有统计学意义(p = 0.0252)。尺侧变异不影响肌腱炎和滑膜炎。操作侧和控制侧ECU的长、短直径相似。短直径不影响滑膜-肌腱炎评分,但长直径越大,滑膜炎评分越高(rho = 0.5162)。结论在存在ECU,肌腱病变伴TFC病变的情况下,关节镜下TFC修复对ECU的愈合无明显影响,需要额外的手术干预。证据等级:4。
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The Effect of Arthroscopic Triangular Fibrocartilage Repair on Accompanying Extensor Carpi Ulnaris Tendinitis and Synovitis in Triangular Fibrocartilage Tears
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.
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