桡骨远端关节内骨折远期腕关节疼痛的病因分析  

The cause analysis of long-term wrist joint pain from intracapsular fracture of distal radius

作　　者：于亚东[1] 邵新中[1] 雷芳[1] 杨春雨[1] 马涛[1] 毕伟东[1] 

机构地区：[1]河北医科大学第三附属医院手外科,石家庄050051

出　　处：《中华关节外科杂志（电子版）》2010年第2期8-9,共2页Chinese Journal of Joint Surgery(Electronic Edition)

摘　　要：目的探讨桡骨远端关节内骨折远期腕关节疼痛的原因。方法对本组共16例桡骨远端关节内骨折远期腕关节疼痛的患者进行X线检查和专科体检,必要时进行CT或MRI检查并进行回顾性研究。原发性骨折按AO分型为23B2型3例,23B3型2例,23C2型7例,23C3型4例;治疗方法为外固定架固定9例,手法整复石膏托外固定3例,克氏针固定结合石膏固定2例,切开复位钢板内固定2例。结果16例患者的主客观检查中发现三角纤维软骨板(TFCC)损伤5例,下尺桡关节炎旋转疼痛4例,关节内游离体3例,桡骨短缩致尺侧撞击综合征2例,尺骨茎突骨不连致腕尺侧疼痛1例,内固定钢板所致伸肌腱鞘炎1例。结论术前充分检查以及选择合适的治疗方法是避免桡骨远端关节内骨折远期腕关节疼痛的有效方法。Objective To analyze the cause of long-term wrist joint pain from intracapsular fracture of distal radius. Methods From July, 2007 to May, 2009, 16 patients who had long-term wrist joint pain from intracapsular fracture of distal radius received X-ray test and professional examination with CT or MRI test necessarily. The results were analyzed and retrospective research was taken. The fractures were divided into 4 groups： 3 cases of 23B2, 2 cases of 23B3, 7 cases of 23C2 and 4 cases of 23C3. Among the patients, 9 received external fixation, 3 received plaster external fixation after manipulative reduction, 2 received Kirschner wire with plaster external fixation and 2 received steel palte internal fixation after open reduction. Results By examinations, we discovered TFCC injury for 5 cases, rotatory pain caused by distal radioulnar joint phlogosis for 4 cases, corpus liberum in the joint for 3 cases, waist pain caused by radius crispation for 1 case, waist pain caused by ulnar malleolus liberation for 1 case and extensor tendon tenosynovitis caused by steel plate for 1 case. Conclusions Preoperative sufficient tests and correct operation method are important to avoid long-term wrist joint pain from intracapsular fracture of distal radius.

关 键 词：桡骨骨折 腕关节 疼痛 

分 类 号：R687.3[医药卫生—骨科学]