Oblique Ulnar Osteotomy For Treatment Of Ulnar Impaction Syndrome And The Outcome Of Carpal Cystic Changes

Objective:To explore the early effect of ulnar oblique osteotomy in the treatment of ulnar impaction syndrome,and analyze the possible causes of cystic degeneration of the wrist in patients with ulnar impaction syndrome and the outcome of the cystic degeneration after ulnar oblique osteotomy.Methods: A retrospective analysis of 22 cases of ulnar impaction syndrome in the General Hospital of Hand and Foot Surgery Ward and the East Hospital of Jining First People’s Hospital from July 2018 to December 2019,and the case data treated by oblique ulnar osteotomy,Followed up for more than 12 months,by comparing the preoperative and last follow-up ulnar variation,visual analog score and modified Mayo wrist score,the clinical effect of the operation was evaluated;from gender,age,hand type,disease course,ulna Comparison of factors such as positive variation,visual analog score,and modified Mayo wrist score,analyze the factors that may cause cystic degeneration of the wrist in patients with ulnar impaction syndrome,and analyze the cystic degeneration of the wrist after ulnar osteotomy.Close follow-up for changes in outcome.Results:(1)All 22 patients were followed up for 12-27 months,and bone healing was achieved at all osteotomy sites.22 patients were compared before and at the last follow-up.Preoperative X-rays were used to check the ulnar variation It was(3.15±1.38)mm,the last follow-up was(-1.56±1.38)mm;the preoperative VAS score was(5.90±1.19)points,and the VAS had been reduced to(1.27±0.94)points at the last follow-up,the difference was statistically significant(t=29.92,P<0.05);the modified Mayo wrist score increased from(62.3±8.70)points before surgery to(80.9±9.70)points,the difference was statistically significant(t=9.83,P<0.05)The above suggests that the correction of oblique ulnar osteotomy is obvious,and the function and pain of the wrist joint of the patient are improved after the operation.(2)Among the 22 patients before the operation,9 patients had carpal cystic degeneration on X-rays,4males and 5 females,all of which were unilateral lesions,4 cases of left hand and 5 cases of right hand,with an average age of 62 years.The average duration of the disease is 15 months;Compared with patients without carpal cystic degeneration,carpal cystic degeneration is correlated with the patient’s age(t=-4.34,P<0.05),and is related to the length of the disease,gender,hand type,and preoperative ulna positive The degree of variation,preoperative VAS score,and preoperative modified Mayo wrist score were not significantly correlated(P>0.05).Conclusion:(1)Oblique ulnar osteotomy is used for patients with ulnar impaction syndrome.After the operation,the wrist pain and function of the patients are improved,which is beneficial to the prognosis of the patients.This method is worthy of strong recommendation.(2)Cystic degeneration of the wrist in patients with ulnar impaction syndrome may be related to the patient’s age,but also to the patient’s duration of disease,gender,hand type,preoperative ulnar variation,preoperative visual analogue score,and preoperative wrist Mayo The scores may not be relevant.(3)In imaging studies,the cystic degeneration of the carpal bone may recover to a certain extent after oblique ulnar osteotomy,and some may even be reversed.