尺骨茎突骨折是否愈合对桡骨远端骨折术后关节功能的影响  

Effect of healing of ulnar styloid fracture on joint function after distal radius fracture surgery

作　　者：叶曙明[1] 徐春归[1] 张积森[1] 许新忠[1] 徐又佳[2] 荆珏华[1] Ye Shuming;Xu Chungui;Zhang Jisen;Xu Xinzhong;Xu Youjia;Jing Juehua(Department of Orthopedics,the Second Affiliated Hospital of Anhui Medical University,Hefei 230601,Anhui Province,China;Department of Orthopedics,the Second Affiliated Hospital of Soochow University,Institute of Osteoporosis Diagnosis and Treatment Technology of Soochow University,Suzhou 235131,Jiangsu Province,China)

机构地区：[1]安徽医科大学第二附属医院骨科,安徽省合肥市230601 [2]苏州大学附属第二医院骨科,苏州大学骨质疏松诊疗技术研究所,江苏省苏州市235131

出　　处：《中国组织工程研究》2020年第33期5321-5325,共5页Chinese Journal of Tissue Engineering Research

基　　金：安徽省高等学校省级质量工程项目(2019jyxm1012),项目负责人:叶曙明。

摘　　要：背景:桡骨远端骨折合并尺骨茎突骨折临床中比较常见,对于有手术适应证的桡骨远端骨折一般选择切开复位钢板内固定手术,但对于尺骨茎突骨折的治疗一直存在争议。目的:观察尺骨茎突骨折愈合与否对桡骨远端骨折内固定术后腕关节功能恢复的影响。方法:选择2016年6月至2019年1月安徽医科大学第二附属医院收治的39例桡骨远端骨折伴尺骨茎突骨折患者,其中男24例,女15例,年龄23-67岁,均接受桡骨远端锁定钢板内固定治疗,随访复查X射线片判定桡骨远端骨折愈合情况。根据末次随访时尺骨茎突愈合情况分为愈合组(n=20)和未愈合组(n=19),依据X射线片比较两组间的掌倾角、尺偏角和桡骨高度,并与健侧进行对比;检测腕关节屈伸活动范围、前臂旋转活动范围和Gartlant-Werley腕关节功能评分。研究获得安徽医科大学第二附属医院伦理委员会批准。结果与结论:①愈合组术后腕关节尺侧疼痛1例,未愈合组尺侧疼痛2例,组间比较差异无显著性意义(P>0.05);两组桡骨骨折愈合时间比较差异无显著性意义(P>0.05);②末次随访时,愈合组与未愈合组的掌倾角、尺偏角均小于健侧(P<0.05),桡骨高度与健侧比较差异无显著性意义(P>0.05);两组间上述指标比较差异均无显著性意义(P>0.05);③末次随访时,愈合组与未愈合组的腕关节背伸、屈曲活动范围均小于健侧(P<0.05),前臂旋转活动范围与健侧比较差异无显著性意义(P>0.05);两组间上述指标比较差异均无显著性意义(P>0.05);④末次随访时,两组Gartlant-Werley腕关节功能评分优良率比较差异无显著性意义(P>0.05);⑤结果表明,尺骨茎突骨折是否愈合对桡骨远端骨折内固定术后腕关节功能的恢复无明显影响,故临床中尺骨茎突骨折可仅行保守治疗。BACKGROUND: Distal radius fractures are often accompanied by a fracture of the ulnar styloid process in clinical practice. For distal radius fractures with surgical indication, open reduction and internal fixation are generally performed. Treatment of ulnar styloid fracture has been controversial. OBJECTIVE: To observe the effect of ulnar styloid fracture healing on the recovery of wrist joint function after internal fixation of distal radius fracture. METHODS: Thirty-nine patients with distal radius fracture combined with ulnar styloid fracture in the Second Affiliated Hospital of Anhui Medical University from June 2016 to January 2019 were enrolled. There were 24 males and 15 females with the age from 23 to 67 years old. All patients were treated with distal radius locking plate fixation. The results of the follow-up review on anteroposterior radiograph were used to determine the healing of the distal radius fractures. According to the healing status of ulnar styloid at the last follow-up, the patients were divided into healing group(n=20) and non-healing group(n=19). The palmar tilt, ulnar inclination and radial height were compared between the two groups based on anteroposterior radiograph and that were compared to the healthy side. The wrist flexion and extension activities, forearm rotation range, and Gartlant-Werley wrist function scores were detected. The study was approved by the Ethics Committee of the Second Affiliated Hospital of Anhui Medical University. RESULTS AND CONCLUSION:(1) There was one case of ulnar-sided wrist pain in the healing group and two cases in the non-healing group;the difference was not statistically significant between the two groups(P>0.05). There was no significant difference in fracture healing time between the two groups(P>0.05).(2) At the last follow-up, palmar tilt and ulnar inclination of the healing group and the non-healing group were smaller than that of the healthy side(P<0.05). However, there was no significant difference in radial height between the healthy side and

关 键 词：骨 桡骨远端 尺骨茎突 骨折 内固定 腕关节 钢板 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学]