带袢钢板和空心螺钉固定治疗下尺桡关节脱位的早期疗效比较  

Comparison of early curative effect between plate with loop and screw fixation for dislocation of lowerradioulnar joint

作　　者：唐曌 包倪荣[1] 王北岳[1] 何志伟[1] 江辉[1] TANG Zhao;BAO Ni-rong;WANG Bei-yue;HE Zhi-wei;JIANG Hui(Department of Orthopaedics,General Hospital of Eastern Theater Command,PLA,Nanjing 210002,Jiangsu,China)

机构地区：[1]东部战区总医院(原南京军区南京总医院)骨科,南京210002

出　　处：《医学研究生学报》2022年第4期383-387,共5页Journal of Medical Postgraduates

基　　金：东部战区总医院科研基金(YYMS2021017)。

摘　　要：目的 对下尺桡关节脱位的手术方式一直缺少统一认识。文中旨在分析比较带袢钢板和空心螺钉固定两种手术方式治疗下尺桡关节脱位的效果。方法 回顾性分析2018年4月至2021年4月东部战区总医院骨科收治的50例下尺桡关节脱位患者的临床资料。根据手术方式分为带袢钢板组(n=25)、空心螺钉组(n=25)。根据术前及随访结果对患者腕关节进行Cooney评分和Gartland-Wedey评分,评价疗效。结果 空心螺钉组、带袢钢板组末次随访Cooney评分[(85.40±17.79)分、(94.40±4.64)分]较术前[(57.20±5.79)分、(55.20±6.84)分]明显升高(P<0.05),带袢钢板组末次随访Cooney评分较空心螺钉组明显升高(P<0.05)。术后X线提示2组下尺桡关节均已复位。末次随访时根据Gartland-Werley腕关节评分,空心螺钉固定组优17例,良8例;带袢钢板固定组优23例,良2例;两组差异有统计学意义(P<0.05)。结论 对于下尺桡关节脱位患者的治疗,空心螺钉固定及带袢钢板固定均可以获得较好的治疗效果。带袢钢板固定治疗下尺桡关节脱位效果优于空心螺钉固定,可获得更优的早期治疗效果。Objective At present, there is no unified understanding of the surgical methods of dislocation of the lower radioulnar joint. In this paper, the comparison and analysis of the early treatment effects of dislocation of the lower radioulnar joint are made between the novel steel plate with loop and the traditional hollow screw fixation. Methods The clinical data of patients with dislocation of lower radioulnar joint who were operated in our hospital from April 2018 to April 2021 were retrospectively collected. According to the operation methods, they were divided into screw fixation group and loop plate fixation group. Collect the data of postoperative follow-up, and evaluate the curative effect by Cooney, Gartland-Werley wrist scoring system at the last follow-up. Results A total of 50 patients were included in the study, including 25 cases in the plate fixation group with loops and 25 cases in the screw fixation group. After the operation, X-ray showed that all the radioulnar joints had been reset. According to Cooney’s wristscore standard, the last follow-up scores of patients before and after operation showed significant difference between groups(P<0.05). The treatment effect of plate fixation with loop was better than that of screw fixation, and the difference was statistically significant(P<0.05). At the last follow-up, according to Gartland-Werley wrist score, 17 cases were excellent in screw fixation group, 8 cases were good, 23 cases were excellent and 2 cases were good in loop plate fixation group(P<0.05). Conclusion For the treatment of dislocation of the lower radioulnar joint, both hollow screw fixation and steel plate fixation with loop can achieve better therapeutic effect. The last follow-up score of plate with loop is higher than that of cannulated screw, suggesting that better early treatment effect may be obtained.

关 键 词：下尺桡关节脱位 带袢钢板 空心螺钉 疗效 

分 类 号：R735.7[医药卫生—肿瘤]