尺骨茎突骨折程度对手法复位治疗桡骨远端骨折预后的影响  

Effect of Ulnar Styloid Fracture Degree on Prognosis of Manipulative Reduction for the Treatment of Distal Radius Fractures

作　　者：黄吉利[1] 潘捷[1] 赵鸿声[1] 

机构地区：[1]江汉大学附属医院骨科,湖北武汉430015

出　　处：《华南国防医学杂志》2016年第3期167-168,189,共3页Military Medical Journal of South China

摘　　要：目的探讨尺骨茎突骨折程度对手法复位治疗桡骨远端骨折预后的影响。方法对纳入研究的108例桡骨远端骨折合并尺骨茎突骨折患者,根据尺骨茎突骨折类型以及移位程度,将研究对象分为3组,A组(46例):Ⅰ型骨折以及尺骨茎突移位≤1 mm的Ⅱ型骨折;B组(42例):1 mm<尺骨茎突移位(Ⅱ型骨折)≤2 mm;C组(20例):尺骨茎突移位(Ⅱ型骨折)>2 mm。3组桡骨远端骨折患者均采用手法复位的方法治疗,在治疗后6个月、12个月采用Cooney评分法评估腕关节功能。结果在治疗后6个月及12个月,A、B组腕关节Cooney评分均高于C组(P<0.05),A、B组无并发症发生,C组患者发生顽固性腕尺侧疼痛2例,腕部复杂区域疼痛综合征2例。结论尺骨茎突骨折程度对手法复位治疗桡骨远端骨折有明显影响,合并尺骨茎突Ⅱ型骨折且移位>2 mm的患者腕关节远期功能恢复相对较差,疼痛发生率较高,应更积极的进行疼痛控制及康复训练。Objective To investigate the effect of ulnar styloid fracture degree on the prognosis of manipulative reduction for the treatment of distal radius fractures.Methods A total of 108 patients with distal radius fractures were studied and their degrees of ulnar styloid fracture were evaluated.All cases were divided into group A（46 cases,typeⅠfracture or typeⅡfracture with displacement≤1 mm）,group B（42 cases,1mmtypeⅡfracture with displacement≤2 mm）and group C（20 cases,typeⅡfracture with displacement2 mm）.The Cooney score of the three groups were compared after 6 month and 12 month.Results Cooney score of group A and group B after 6 month were higher than that of group C（P〈0.05）.Group A and B had no complications.There were 2 cases with intractable ulnar wrist pain and 2 cases with complex regional pain syndrome in group C.Conclusion The degree of ulnar styloid fracture has clear effect on the manipulative reduction treatment of distal radius fractures.Type Ⅱ fracture with displacement more than2 mm means relatively poor wrist joint function in long-term functional recovery and a higher incidence of pain in patients.More active control and rehabilitation training on pain and functional recovery is needed.

关 键 词：尺骨茎突骨折 桡骨远端骨折 手法复位 预后 

分 类 号：R683.41[医药卫生—骨科学]