桡骨远端骨折后下尺桡关节对应关系的变化及临床意义  

Effect on the distal radioulnar joint after reduction in fracture of the distal radius

作　　者：杨彬[1] 王金泉[1] 李燕敏[1] 尹晓[1] 王功国[1] 王祥杰[1] 陈卫衡[2] 

机构地区：[1]日照市中医医院骨科,山东日照276800 [2]中国中医科学院望京医院

出　　处：《中国骨伤》2007年第5期317-319,共3页China Journal of Orthopaedics and Traumatology

摘　　要：目的：研究桡骨远端骨折整复后桡骨纵向短缩距离（△h）对下尺桡关节旋转功能的影响。方法：临床60例患者，分别测定每一例患者桡骨远端骨折拆除外固定后桡骨纵向短缩距离△h和下尺桡关节的旋转受限角度γ，△h根据临床测定值分为0mm～、2mm～、4mm～、≥5mm4个区间，γ根据疗效评定标准分为优、良、可、差4个等级。分别计算出在每个区间上的优良可差的例数，并作统计学处理，得出相应的结论。结果：①无尺侧变异组：40例，相关系数r=0．7402，P〈0．0005，2mm～与4mm～组间P〈0．05。②正向变异组：10例，相关系数r=0．7576，0．0005〈P〈0．001，△h在0mm～与2mm～组间P=0．02〈0．05。③负向变异组：10例，相关系数r=0．8242，0．0005〈P〈0．001，△h在4mm～与≥5mm组间P：0．005〈0．01。结论：①无尺侧变异组：桡骨远端骨折整复后短缩距离△h≥4mm时，下尺桡关节旋转功能受限严重，故△h〈4mm。②正向变异组：桡骨远端骨折整复后短缩距离△h≥2mm时，下尺桡关节旋转功能受限严重，故△h〈2mm。③负向变异组：桡骨远端骨折整复后短缩距离△h≥5mm时，下尺桡关节旋转功能受限严重，故△h〈5mm。Objective：To study the effect of the radius shorten distance after reduction in fracture of the distal radius, in case to construct a standard to reduce the complications and improve the rate of cure. Methods： Sixty cases of patients, Ah and γ were measured. The shorten distance of the distal radius was marked with Ah, the limited degree of the wrist joint was marked with γ. According to the results of clinical measuring, the data of Ah was divided into four intervals ：0 mm - ,2mm - ,4 mm -,≥ 5 mm. According to the standard, the data of γ was divided into four degrees ： excellent, well, common, inferior. Then Ah and γ were disposed by statistical method. Results：First, analyzing the patients without ulnar variant, there was statistical meaning between 2 mm - and 4 mm - of Ah for P 〈0. 05. Second,analyzing the patients with plus variant,there was statistical meaning between 0 nun - and 2 mm - of Ah for 0. 000 5 〈 P 〈 0. 001. Third, analyzing the patients with minius variant, there was distinct difference between 4 mm - and ≥ 5 mm of △h for P = 0. 005 〈 0. 01. Condusion：①When△h ≥4 mm, the rotary function of the distal radioulnar joint is seriously limited in the patients without ulnar variant. ②When △h≥2 mm,the rotary function of the distal radioulnar joint is seriously limited in the patients with plus variant. ③When △h ≥5 nun, the rotary function of the distal radioulnar joint is seriously limited in the patients with minius variant.

关 键 词：桡骨骨折 手法 骨科 下尺桡关节 

分 类 号：R683.41[医药卫生—骨科学]