钩钢板治疗不稳定尺骨远端骨折合并桡骨远端骨折的疗效  

Efficacy of hook-plate osteosynthesis in the treatment of unstable distal ulnar fracture combined with distal radial fracture

作　　者：冷昆鹏 孟钰童 刘洋[1] 尹博[1] 周君琳[1] Leng Kunpeng;Meng Yutong;Liu Yang;Yin Bo;Zhou Junlin(Department of Orthopedics,Beijing Chao-Yang Hospital,Capital Medical University,Beijing 100020,China)

机构地区：[1]首都医科大学附属北京朝阳医院骨科,100020

出　　处：《中华肩肘外科电子杂志》2023年第4期344-349,共6页Chinese Journal of Shoulder and Elbow(Electronic Edition)

基　　金：国家自然科学基金资助项目(82002280);国家自然科学基金资助项目(82272469);北京市自然科学基金资助项目(7234371);北京市临床重点专科项目经费资助(BJYQFZ-2022)。

摘　　要：目的回顾性分析应用钩钢板治疗不稳定尺骨远端骨折合并桡骨远端骨折的临床疗效。方法选取2018年1月至2022年5月本院收治的31例不稳定尺骨远端骨折合并桡骨远端骨折患者作为研究对象,临床疗效评估包括患者腕关节活动范围、握力、快速臂肩手障碍评分(quick disabilities of the arm,shoulder and hand,Q-DASH)和Mayo腕关节评分,通过术后X线评估桡骨高度、尺骨变异、掌倾角、尺偏角和骨折愈合情况。结果共31例患者,平均年龄为(66±9)岁,平均随访时间为(15±3)个月。最终随访时,腕关节活动度平均掌屈为(49±7)°、背伸(45±6)°、旋前(81±4)°、旋后(79±5)°,握力为(19±6)kg。临床评分为良好至优秀,平均Q-DASH评分为(14±9)分,Mayo腕关节评分为(87±7)分。结论钩钢板是不稳定尺骨远端骨折合并桡骨远端骨折患者手术治疗的理想选择,通过早期康复锻炼可以获得满意的腕关节功能恢复。Background Distal ulnar and distal radial fractures are rare injuries,accounting for approximately 5.6%of all distal radial fractures.There is some controversy regarding the treatment methods for distal ulnar fractures.Some literature suggests that the clinical outcomes of distal ulnar fractures treated conservatively are poor.Unstable distal ulnar fractures may affect the function of the distal radioulnar joint and forearm rotation stability,leading to nonunion,chronic wrist pain,and instability.Consequently,some scholars recommend surgical treatment for unstable or displaced distal ulnar fractures after fixation of the distal radial fractures.For small distal ulnar fracture fragments,particularly in elderly patients with osteoporotic fractures,the effectiveness of internal fixation methods such as Kirschner wires or locking plates is limited.In comparison,the ulna distal locking hook plate presents advantages in anatomical design and smooth edges,reducing irritation to soft tissues and decreasing the risk of reduction loss,thus achieving a more robust fracture fixation.Objective To retrospectively analyze the clinical effect of hook-plate osteosynthesis in the treatment of unstable distal ulnar fracture combined with distal radial fracture.Methods Thirty-one cases of unstable distal ulnar fractures combined with distal radial fractures were admitted to our hospital from January 2018 to May 2022 and selected as the subjects for the study.Clinical efficacy assessment included wrist joint range of motion,grip strength,Q-DASH score,and Mayo wrist joint score.Postoperative X-ray evaluations were conducted to assess radial height,ulnar variance,volar tilt,ulnar tilt,and fracture healing status.Results Thirty-one patients were included in this study,with an average age of(66±9)years and a mean follow-up duration of(15±3)months.At the final follow-up,the average wrist joint range of motion was as follows:(49±7)°of palmar flexion,(45±6)°of dorsiflexion,(81±4)°of pronation,and(79±5)°of supination.Grip strength

关 键 词：不稳定尺骨远端骨折 钩钢板 桡骨远端骨折 

分 类 号：R687.3[医药卫生—骨科学]