桡骨头骨折合并下尺桡关节脱位损伤误诊误治2例报告  

Error diagnosis and inappropriate treatment for Essex-Lopresti injury in 2 cases

作　　者：陈建良[1] 张龙君[1] 叶锋[1] 郑晓东[1] 许勇[1] 

机构地区：[1]上虞市中医院骨科,浙江上虞312300

出　　处：《中国骨伤》2010年第11期877-878,共2页China Journal of Orthopaedics and Traumatology

摘　　要：目的:分析桡骨头骨折合并下尺桡关节脱位(Essex-Lopresti损伤)误诊误治的原因并探讨合理治疗方法。方法:2008年至2009年治疗2例桡骨头骨折合并下尺桡关节脱位患者,均为男性,年龄分别为56岁、66岁。摔倒致肘部肿胀压痛、前臂旋转受限明显。X线示桡骨小头粉碎性骨折,MasonⅢ型1例、Ⅳ型1例。均行桡骨小头切除术,术后常规石膏固定对症处理。结果:2例均出现前臂旋转功能受限明显伴肘关节、下尺桡关节疼痛。X线示下尺桡关节分离明显,桡骨近端移位。结论:Essex-Lopresti损伤早期诊断治疗很重要。在不能有效修复重建骨间膜时,重建桡骨长度的同时对下尺桡关节复位固定是治疗的有效方法。Objective：To analyze the reason of error diagnosis and inappropriate treatment of radius head fractures com- plicating distal radioulnar joint dislocation （Essex-Lopresti injury） and to seek for the reasonable treatment. Methods：From 2008 to 2009,2 male patients of radius head fractures complicating distal radioulnar joint dislocation were treated,the age was 56 and 66 years old respectively. The symptom included elbow swelling and limitation of forearm rotation. X-ray showed com- minuted fractures of capitulum radius. There were 1 case of Mason type Ⅲ and 1 cases of type Ⅳ. Two patients were treated by resection of capitulum radius and plaster fixation after operation. Results：Both of the 2 cases had limited rotation of forearm and the distal radioulnar joint pain. The X ray showed that the distal radioulnar joint was separated obviously and the proximal radius was translocated. Conclusion：The early diagnosis is very important for the Essex-Lopresti injury. Rebuilding the longth of the radius and reduction fixating the distal radioulnar joint after fixated is an effective treatment while the interosseous membranes can＇t be repaired and rebuilded.

关 键 词：桡骨骨折 前臂损伤 脱位 误诊 治疗失误 

分 类 号：R683.41[医药卫生—骨科学]