桡骨截骨延长联合尺骨短缩术治疗桡骨远端畸形  

Radial lengthening osteotomy combined with ulnar shortening for distal radius deformity

作　　者：田勇 田江波 武艺龙 董家赫 尚万山 张海龙 王孝辉 TIAN Yong;TIAN Jiangbo;WU Yilong;DONG Jiahe;SHANG Wanshan;ZHANG Hailong;WANG Xiaohui(Graduate School of Henan University of Chinese Medicine,Zhengzhou,Henan 450046,China;不详)

机构地区：[1]河南中医药大学研究生院,河南郑州450046 [2]河南省洛阳正骨医院(河南省骨科医院)运动医学、关节镜二科,河南洛阳471002

出　　处：《中国骨与关节损伤杂志》2024年第11期1155-1159,共5页Chinese Journal of Bone and Joint Injury

基　　金：洛阳市科技发展计划项目(2202010A)。

摘　　要：目的 观察桡骨远端截骨延长联合尺骨缩短术治疗桡骨远端骨折畸形愈合的临床疗效。方法 回顾性分析自2015-06-2021-03采用尺骨截骨缩短术联合桡骨远端截骨延长术结合腕关节镜治疗的8例桡骨远端骨折严重缩短畸形愈合,比较术前与术后腕关节影像学参数、旋前、旋后、屈伸及尺桡偏活动度,并应用Gartland-Werley评分标准评定术后疗效。结果 所有患者均得到有效随访,随访时间12~24个月,平均16个月。所有患者均达到手术目的,尺桡关节均对位良好。术前桡骨高度-32~-18 mm,平均-26.62 mm;术后1年,恢复为9~14 mm,平均11.75 mm。术前尺偏角7°~43°,平均23.00°;术后1年,恢复为15°~25°,平均19.37°。术前掌倾角-12°~22°,平均0.00°;术后1年,恢复为5°~13°,平均9.63°。术前前屈活动度18°~34°,平均26.32°;术后1年,55°~74°,平均68.52°。术前后伸活动度21°~32°,平均27.58°;术后1年,47°~68°,平均59.53°。术前旋前活动度27°~43°,平均35.46°;术后1年,63°~82°,平均72.43°。术前旋后活动度37°~52°,平均45.82°;术后1年,61°~75°,平均69.61°。术前桡偏活动度6°~15°,平均9.08°;术后1年,17°~23°,平均19.48°。术前尺偏活动度9°~14°,平均11.79°;术后1年,27°~41°,平均34.99°。末次随访根据Gartland-Werley评分标准评定疗效:优4例,良3例,可1例,优良率87.5%。术后未出现感染与骨折不愈合情况。结论 桡骨远端截骨延长合并尺骨缩短术治疗桡骨远端骨折畸形愈合,对腕关节外观和功能恢复有着较好的疗效。Objective To observe the clinical efficacy of distal radial lengthening osteotomy combined with ulnar shortening os-teotomy for the treatment of malunion of distal radial fractures.Methods A retrospective analysis was conducted on eight cases of severe shortening malunion of distal radial fractures treated with ulnar shortening osteotomy combined with distal radial lengthening osteotomy and wrist arthroscopy from June 2015 to March 2021.Preoperative and postoperative wrist joint imaging parameters,pronation,supination,flexion,extension,and ulnar and radial deviation ranges of motion were compared.The post-operative efficacy was evaluated using the Gartland-Werley scoring system.Results All patients were followed up effectively for 12 to 24 months,averaging 16 months.All patients achieved the intended surgical objectives,and the radioulnar joints were well-aligned in all cases.Preoperative radial height ranged from-32 to-18 mm,with an average of-26.62 mm;one year post-operatively,it recovered to a range of 9 to 14 mm,with an average of 11.75 mm.The preoperative ulnar deviation angle ranged from 7°to 43°,with an average of 23.00°;one year postoperatively,it recovered to a range of 15°to 25°,with an average of 19.37°.The preoperative palmar inclination angle ranged from-12°to 22°,with an average of 0.00°;one year postoperatively,it recovered to a range of 5°to 13°,with an average of 9.63°.The preoperative flexion range of motion ranged from 18°to 34°,with an average of 26.32°;one year postoperatively,it improved to a range of 55°to 74°,with an average of 68.52°.The preoperative extension range of motion ranged from 21°to 32°,with an average of 27.58°;one year postoperatively,it improved to a range of 47°to 68°,with an average of 59.53°.The preoperative pronation range of motion ranged from 27°to 43°,with an average of 35.46°;one year postoperatively,it improved to a range of 63°to 82°,with an average of 72.43°.The preoperative supination range of motion ranged from 37°to 52°,with an a

关 键 词：桡骨截骨延长术 尺骨缩短术 畸形 关节镜 下尺桡关节 

分 类 号：R687.3[医药卫生—骨科学]