Ulnar Impaction Syndrome After Treatment Of The Distal Radius Fractures

Objectives We investigate the change of ulnar impaction syndrome images after the distal radius fracture, in order to strengthen the understanding of ulnar impaction syndrome. To study the relationship between the ulnar variance range and function of wrist joint range of motion limited. To explore the factors related to the ulnar positive variance, guide the treatment of distal radius fracture and reduce the occurrence of the ulnar wrist pain.Methods We selected the patients sustaining wrist ulnar pain after being treated close fracture of the distal radius from January 2008 to January 2012 at the second hospital of Tangshan, There were 56 cases which have been confirmed the diagnosis of ulnocarpal impaction syndrome. We collected the clinical information of patients, include: gender, age, injury mechanism, classification, treatment methods, ulnar variance situation at X-ray, MRI, Mayo wrist function score. We analyzed wrist imaging changes at ulnar impaction syndrome, the relationship between the ulnar variance degree and wrist function limited and the factors related to the ulnar positive variance. We pooled the clinical data, create database tables, the data were statistically analyzed using SPSS 17.0.Results 1 Ulnar positive variance was found with X-ray in 39 cases(69.4%), neutral variation in 11 cases(19.6%), 6 patients with negative variation(10.7%). This group of positive variance with Mayo score: excellent in 3 cases, ulnar average variatio n of 2.1±0.15mm; good in 9 cases, ulnar average variation of 4.5±1.5mm; fair in 16 cases, ulnar average variation of 8.8±3.3mm; poor in 11 cases, ulnar average variation of 15.9±4.5mm. Difference in variation of poor group of more than excellent, good and fair group(P<0.05); variation degree group of fair more than that of excellent group had statistical significance(P<0.05). Ulnar variance height average was 9.2±5.3mm, wrist score was 70.6±13.5, a high negative correlation between the score of ulna height variation and wrist joint function(r=-0.92, P<0.01). 2 The gender factor incidence compared in the ulnar positive variance was not statistical significance(P>0.05); ≥60 years old group was significantly higher than that of ulnar positive variance in <60 years old group(P<0.05), with statistical significance; comparison of the incidence of A, B, C type, 3 type fractures of the ulna positive variance were statistically significance(P<0.05); the positive rate of ulnar with high energy injury is significantly higher than the low energy damage( P<0.05), the difference was statistically significant; conservative treatment of ulnar positive incidence was significantly higher than that of operation treatment(P<0.05), there was statistical significance. 3 X-ray examination found wrist bone destruction in 16 cases, accounted for 28.6%. MRI examination was used in 25 cases who revealed early carpal signal change. The detection ratio was 100%. Which was significantly better than the X-ray examination(P<0.01).Conclusions 1 We found that the ulnar variation range was closely relevant to wrist functional restriction after distal radius fractures. 2 60 years or older, type of fracture, high energy injury, conservative treatment are the risk factors of ulnar variation. 3 Positivedetection rate of ulnar impaction syndrome with MRI was significantly higher than that of X-ray examination.