键盘鼠标操作致尺骨撞击综合征的诊断及原因分析

目的探讨键盘鼠标操作引起腕部尺骨撞击综合征的原因。方法2004-12~2007-12诊断为尺侧撞击综合征的长期键盘鼠标操作者33例,利用物理检查及影像学检查,分析操作键盘鼠标引起尺骨撞击综合征的原因。结果尺骨阳性变异13例(39.3%),10例尺骨中性变异患者在握拳、旋前位能够诱发尺骨动态阳性变异(66.7%);13例(92.9%)出现腕骨MRI信号改变,信号改位于腕骨、尺骨头相对部位;13例(92.9%)出现三角纤维软骨(Triangular fibrocartilage,TFC)损伤,部位多在尺侧及中央部(76.9%)。结论长时间反复键盘鼠标操作,使腕部频繁或高重复性尺偏、旋前,加剧或诱发尺骨动态阳性,导致尺骨头密集地撞击TFC和腕骨,造成尺骨撞击综合征。

Ulnar impaction syndrome caused by manipulating keyboard and mouse: An analysis of the diagnosis and pathogenesis

Objective To explore the reason of carpal ulnar impaction syndrome caused by manipula-ting keyboard and mouse.Method From December 2004 to December 2007,33 cases were diagnosed as ulnar impaction syndrome who operating keyboard and mouse of computer for long time everyday.Physical examination and image check of injuried wrist were taken to analyse and search for what led to ulnar inpaction syndrome for those people.Result Thirteen cases of ulnar impaction syndrome had positive ulnar variance(39.3%).Dynamic positive ulnar variance could be evoked in ten cases(66.7%)of neutral ulnar variance when they gripped their fists and pronated their wrists.Abnormal MRI signal intensity of carpale were found in 13 cases(92.9%)and the sites of signal alteration located at ulnar side of lunate or(and)at the waist and bottom of triquetrum,and the proximal radialis of head of ulna.Thirteen wrists(92.9%)were found to have triangular fibrocartilage(TFC)injury at the ulnar side or(and)the central parts.Conclusion Ulnar impaction syndrome could be induced by repeated manipulating keyboard and mouse for long time when those computer handlers made wrist joint ulnar deviate and pronate,which could provocate carpal dynamic positive ulnar variance and result in head of ulna impacting TFC and carpal bone at last.