桡骨远端骨折合并移位型尺骨茎突骨折的手术治疗研究  

Two surgical treatments for distal radius fractures combined with displaced fracture of processus styloideus ulnae

作　　者：丁欢[1] 朱燕辉[1] 陶海荣[1] 金晨[1] 刘勇章[1] 胡小鹏[1] 

机构地区：[1]上海交通大学医学院附属第三人民医院骨科,上海201900

出　　处：《中国骨与关节外科》2012年第6期493-496,共4页Chinese Journal of Bone and Joint Surgery

摘　　要：背景:在对桡骨远端骨折合并移位型尺骨茎突骨折患者的处理中,尺骨茎突是否需要手术固定尚存争议。目的:比较两种不同手术方法固定桡骨远端骨折合并移位型尺骨茎突骨折的临床疗效。方法:2007年5至2010年3月手术治疗桡骨远端骨折合并移位型尺骨茎突骨折(HauckⅡ型,移位>2mm)39例,其中单纯桡骨远端切除复位内固定(单纯桡骨固定组)22例,桡骨远端骨折固定合并尺骨茎突骨折切开复位内固定(尺桡骨远端固定组)17例,术后指导功能锻炼。结果:所有患者均获得随访。随访时间为12～26个月,平均19个月。术后3个月两组的腕关节Gartland-Werley评分无统计学差异(P>0.05);术后1年两组的腕关节Gartland-Werley评分、掌屈及尺偏功能无统计学差异(P>0.05),尺侧疼痛评分有显著性差异(P<0.05)。结论:对于桡骨远端骨折合并移位型尺骨茎突骨折患者而言,桡骨远端骨折固定合并尺骨茎突骨折切开复位内固定优于单纯桡骨远端切除复位内固定。Background： Whether or not ulnar malleolus is necessary to be treated in the patients with distal radius fracture and displaced fracture of ulnar malleolus. Objective： The aim of the study is to evaluate the two fixation methods for distal radius fractures combined with displaced fracture of ulnar malleolus. Methods： Totally 39 patients with distal radius fractures and displaced fracture of ulnar malleolus （Hauck II, and the displacement of ulnar malleolus is more than 2 mm） were treated from May 2007 to March 2010 in our hospital. Of them, 22 were treated with radial internal fixation and 17 with internal fixation of distal radius and ulnar malleolus. All the patients did functional exercise after surgery. Results： All the patients were followed up with an average time of 19 months （range, 12 to 26 months）. There was no significant difference in Gartland-Werley scores for wrist joint between two groups 3 months postoperatively （P 〉 0.05）. One year after surgery, there were no significant differences in terms of Gartland-Werley scores for wrist joint, volar flexion and ulnar deviation between two groups （P〉 0.05）, while there was significant difference in ulnar pain score （P〈 0.05）. Conclusions： The open reduction and internal fixation of radius and ulnar malleolus is superior to radial internal fixation in the treatment of distal radius fracture combined with displaced fracture ofprocessus styloideus ulnae.

关 键 词：桡骨远端骨折 尺骨茎突 内固定 

分 类 号：R687.3[医药卫生—骨科学]