尺骨茎突骨折固定与否对桡尺远侧关节旋转稳定性的影响  

The impacts of ulnar styloid fracture on the biomechanics of the distal radioulnar joint

作　　者：董加纯[1] 尹望平[1] 陈延超[1] 颜冰珊[1] 孙剑伟[1] 聂文忠[2] 

机构地区：[1]复旦大学附属金山医院骨科,上海201508 [2]上海应用技术学院

出　　处：《中华手外科杂志》2015年第4期266-268,共3页Chinese Journal of Hand Surgery

基　　金：上海市卫生局面上项目（20114019）

摘　　要：目的 探讨桡骨远端不稳定骨折内固定后,尺骨茎突骨折固定与否对桡尺远侧关节旋转稳定性的影响.方法 在10具新鲜的上肢标本上建立桡骨远端不稳定型（AO分型的C1.2）骨折掌侧锁定钢板固定模型后,比较尺骨茎突无骨折、尺骨茎突骨折不固定和空心螺钉内固定3种状况下,前臂最大旋前和旋后时扭矩的变化.结果 最大旋前扭矩和旋后扭矩：对照组（组1）为（0.75±0.22）N·m和（1.06±0.45）N·m,尺骨茎突无骨折（组2）为（0.69±0.17） N·m和（0.69±0.22）N·m,骨折时（组3）为（0.63±0.19） N·m和（0.61±0.17）N·m,尺骨茎突骨折固定时（组4）为（0.67±0.20）N·m和（0.70±0.30）N·m;骨折组（组3）最大旋前和旋后扭矩均小于无骨折组（组2）和尺骨茎突骨折固定（组4）2组,差异具有统计学意义.而尺骨茎突无骨折与茎突骨折固定（组2与组4）相比差异无统计学意义.结论 桡骨远端不稳定型（AO分型的C1.2）骨折掌侧锁定钢板固定后,固定尺骨茎突基底骨折可以提高桡尺远侧关节的旋转稳定性.Objective To determine whether an associated ulnar styloid fracture following fixation of an unstable distal radius fracture has any effect on distal radioulnar joint （DRUJ） stability.Methods Unstable distal radius fracture （AO type C1.2） model was created on 10 fresh upper limb cadaver specimens.The fracture was fixed with volar locking plate.The rotation torque was measured when the ulna styloid process was intact,when it was fractured but not fixed,and when it was fractured and fixed with a cannulated screw.The changes of the maximum pronation and supination torque under these three different condidoas were observed.Results The maximum pronation and supination torque were （0.75 ± 0.22） N·m and （1.06 ± 0.45） N·m in the control model,（0.69 ± 0.17）N·m and （0.69 ± 0.22） N· m in the normal ulnar styloid model,（0.63 ± 0.19） N· m and （0.61 ± 0.17） N· m in the ulnar styloid fracture model,and （0.67 ± 0.20） N· m and （0.70 ± 0.30） N· m in ulnar styloid fracture fixation model.The rotation torque in the ulnar styloid fracture model was lower less than those in the normal ulnar styloid and ulnar styloid fracture fixation models.The difference was statistically significant.However,there was no difference in the rotation torque between ulnar sty loid fracture fixation model and normal ulnar styloid model.Conclusion Fixation of ulnar styloid process fracture can improve the rotation stability of DRUJ following volar locking plate fixation of unstable distal radius fractures.

关 键 词：尺骨骨折 生物力学 桡尺远侧关节 

分 类 号：R683.41[医药卫生—骨科学]