尺骨茎突骨折对桡尺远侧关节稳定性影响  

The impact of ulnar styioid fracture on the stability of the distal radioulnar joint

作　　者：杨焕友[1] 张楠[1] 杨振建[1] 李瑞国[1] 王斌[1] 刘德群[1] 李浩[2] 

机构地区：[1]唐山市第二医院手外科,063000 [2]山东省聊城市人民医院手足外科

出　　处：《中华手外科杂志》2014年第2期115-117,共3页Chinese Journal of Hand Surgery

摘　　要：目的研究各型尺骨茎突骨折手术治疗与非手术治疗对桡尺远侧关节稳定性的影响。方法2001年8月至2010年5月，对150例尺骨茎突骨折患者，其中I型骨折68例、Ⅱ型骨折82例，通过术前影像学测量，术后随访桡尺远侧关节稳定性，对腕关节功能进行评定。结果通过腕关节标准侧位片，在豆舟骨间距≤3mm时，测量桡尺远侧关节间距，尺骨茎突骨折工型桡尺远侧关节间距≤5mm，Ⅱ型≥5mm。术后随访时间为26～102个月，平均70个月。桡尺远侧关节稳定性：68例工型骨折未出现桡尺远侧关节松弛，82例Ⅱ型骨折中11例出现桡尺远侧关节松弛。腕关节功能评定采用Green-O’Brien评分法：工型骨折手术治疗28例，其中优12例、良11例，优良率为82．1％；非手术治疗40例，其中优10例、良19例，优良率为72．5％。Ⅱ型骨折手术治疗72例，其中优62例、良6例，优良率为94．4％；非手术治疗10例，其中优1例、良2例，优良率为30．0％。结论尺骨茎突骨折对桡尺远侧关节稳定性的影响，I型较小，Ⅱ型较大。所以对Ⅱ型尺骨茎突骨折应采用手术治疗，使其解剖复位。Objective To investigate the impact on distal radioulnar joint（DRUJ） stability by various types of ulnar styloid fractures surgically and non-surgically treated. Methods A total of 150 cases of ulnar styloid fractures treated between August 2001 and May 2010 were involved in this study. There were 68 cases of type fractures and 82 cases of type fractures. Preoperative radiographic measurements, postoperative evaluation of DRUJ stability and wrist function were carried out. Results Preoperatively spacing of the DRUJ was measured on standard lateral wrist X-Rays when the distance from the pisiform to the scaphoid was less than 3 mm. The spacing was less than 5 mm in type I fractures and more than 5 mm in type fractures. All the patients were follow-up for 26 to 102 months, with an average of 70 months. There was no relaxation of the DRUJ among 68 type cases, whereas DRUJ relaxation occurred in of the 82 type cases. Evaluation of wrist function using Green-O＇Brien evaluation criteria revealed excellent results in 12 and good results in 11 of the 28 type I ulnar styloid fracture cases treated surgically. The overall satisfactory rate of this cohort was 82.1%. Of the 40 non-surgically treated type cases, results were rated as excellent in 10 cases and good in 19 cases, with an overall satisfactory rate of 72.5 %. 72 of type ulnar styloid fractures were surgically treated leading to excellent results in 62 cases and good results in 6 cases, with a 94.4% satisfactory rate. Non-surgical treatment of the other 10 type cases led to excellent resuhs in case and good results in 2 cases, achieving a 30.0% satisfactory rate. Conclusion Type I ulnar styloid fractures have less impact on DRUJ stability than type fractures. Type ulnar styloid fractures therefore should be surgically treated to achieve anatomical reduction and preserve DRUJ stability.

关 键 词：骨折 桡腕关节 治疗结果 尺骨茎突 

分 类 号：R687.3[医药卫生—骨科学]