急性桡尺远侧关节脱位的诊治分析  

Analysis of diagnose and treatment for the acute distal radioulnar joint dislocation

作　　者：谢辉[1] 胡勇[2] 章伟文[1] 陈宏[1] 王欣[1] 

机构地区：[1]宁波市第六医院手外科宁波市手外科研究所,浙江宁波315040 [2]宁波市第六医院骨二科

出　　处：《中国骨伤》2007年第8期512-514,共3页China Journal of Orthopaedics and Traumatology

摘　　要：目的：探讨急性桡尺远侧关节脱位的临床特点和治疗方法。方法：桡尺远侧关节脱位患者23例,其中男13例,女10例;年龄28-56岁,平均41岁。Galeazzi骨折18例,单纯桡尺远侧关节脱位5例。尺骨头向掌侧脱位13例,向背侧脱位10例。急性桡尺远侧关节脱位行手法复位,应用克氏针和（或）空心拉力螺钉固定。结果：23例术后随访6-32个月,平均22个月。18例腕痛消失,5例有轻微疼痛及不适。腕关节掌屈（53°±5°）,为健侧的（81.5%±5.0%）;背伸（51°±8°）,为健侧的（83.6%±7.0%）;桡偏（13°±4°）,为健侧的（76.5%±5.0%）;尺偏（27°±6°）,为健侧的（77.1%±8.0%）;前臂旋前（78°±6°）,为健侧的（88.6%±8.0%）;旋后（80°±7°）,为健侧的（88.8%±7.0%）;握力和捏力分别达健侧的（87.5%±6.0%）和（92.0%±7.0%）。20例恢复了原工作,3例改为轻工作。结论：桡尺远侧关节脱位常合并其他损伤,应用空心拉力螺钉或克氏针是治疗急性远侧桡尺关节脱位有效方法之一。Objective：To investigate the clinical characteristics and treatment of the acute distal radioulnar joint dislocation. Methods：Twenty-three patients （13 male, 10 female,the averge age of 41 years ranging from 28 to 56 years ） with acute distal radioulnar joint dislocation were treated with manipulative reduction and hollow lag screws or Kirschner wire procedure. Eighteen cases were Galeazzi fracture,5 cases were pure distal radioulnar joint dislocation. Thirteen cases were palm-dislocation of head of ulna, 10 cases were dorso-dislocation of head of ulna. Results： Twenty-three patients were followed-up for 6 to 32 months （mean 22 months）. Wrist pain was completely relieved in 18 patients,while residual discomfort or minimal pain was observed in 5 patients. The ranges of motion of the wrist was （ 53 °± 5° ） of flexion, （ 51 ° ± 8 ° ） of extension, （ 13°± 4° ） of radial deviation, （27°±6°） of ulna deviation, （78°±6°） of pronation,and （80°±7°） supination,being （81.5% ±5.0% ）, （83.6% ±7.0%） ,（76. 5% ±5.0%） ,（77.1% ±8.0% ） ,（88.6% ±8.0% ） and （88.8% ±7.0% ） of the opposite side respectively. The grip and pinch strength reached respectively （87.5% ±6.0% ） and （92. 0% ±7.0% ） of the opposite side in 23 eases. Twenty patients returned to their previous job,and rest 3 changed into lighter job. Conclusion：The distal radioulnar joint is frequently combined with other trauma. One of effective ways of the fresh distal radioulnar joint dislocation is treated with hollow lag screws or Kirschner wire procedure.

关 键 词：腕关节 桡尺远侧关节 脱位 骨折固定术 内 

分 类 号：R684.7[医药卫生—骨科学]