| 不固定下尺桡关节治疗桡骨远端骨折合并下尺桡关节不稳定的病例对照研究 |
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投稿时间：2011-07-06
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| 作者 | Author | 单位 | Address | E-Mail |
| 刘杰 |
LIU Jie |
同济大学附属第十人民医院骨科 上海市创伤急救中心，上海 200072 |
Department of Orthopaedics, the Tenth People's Hospital of Shanghai, Tongji University, Trauma and Emergency Center of Shanghai, Shanghai, 200072, China |
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| 李少华 |
LI Shao-hua |
同济大学附属第十人民医院骨科 上海市创伤急救中心，上海 200072 |
Department of Orthopaedics, the Tenth People's Hospital of Shanghai, Tongji University, Trauma and Emergency Center of Shanghai, Shanghai, 200072, China |
doctorli77@163.com |
| 蔡郑东 |
CAI Zheng-dong |
同济大学附属第十人民医院骨科 上海市创伤急救中心，上海 200072 |
Department of Orthopaedics, the Tenth People's Hospital of Shanghai, Tongji University, Trauma and Emergency Center of Shanghai, Shanghai, 200072, China |
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| 李振华 |
LI Zhen-hua |
同济大学附属第十人民医院骨科 上海市创伤急救中心，上海 200072 |
Department of Orthopaedics, the Tenth People's Hospital of Shanghai, Tongji University, Trauma and Emergency Center of Shanghai, Shanghai, 200072, China |
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| 王建广 |
WANG Jian-guang |
同济大学附属第十人民医院骨科 上海市创伤急救中心，上海 200072 |
Department of Orthopaedics, the Tenth People's Hospital of Shanghai, Tongji University, Trauma and Emergency Center of Shanghai, Shanghai, 200072, China |
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| 张磊 |
ZHANG Lei |
同济大学附属第十人民医院骨科 上海市创伤急救中心，上海 200072 |
Department of Orthopaedics, the Tenth People's Hospital of Shanghai, Tongji University, Trauma and Emergency Center of Shanghai, Shanghai, 200072, China |
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| 余磊 |
YU Lei |
同济大学附属第十人民医院骨科 上海市创伤急救中心，上海 200072 |
Department of Orthopaedics, the Tenth People's Hospital of Shanghai, Tongji University, Trauma and Emergency Center of Shanghai, Shanghai, 200072, China |
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| 期刊信息：《中国骨伤》2011年，第24卷，第11期，第890-893页 |
| DOI：10.3969/j.issn.1003-0034.2011.11.002 |
| 基金项目: |
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中文摘要:
目的：探讨桡骨远端骨折合并下尺桡关节不稳的治疗方式。
方法：2007 年6 月至2009 年12 月，采取切开复位内固定治疗不稳定型桡骨远端骨折264例，其中42例术中发现合并下尺桡关节不稳，20例采取克氏针固定下尺桡关节或旋后位石膏外固定治疗(固定组),22例未行固定(非固定组).术后对握力和腕关节活动范围进行观察；采用Sarmiento改良的Gartland-Werley评分系统(GW评分)对腕部功能进行评估，并测试下尺桡关节稳定性。
结果：41例患者均获得1年以上随访，所有患者桡骨远端骨折均在术后3个月内获得愈合，下尺桡关节均对合良好，没有出现明显半脱位或脱位。两组患者的握力、腕关节活动范围及GW评分差异无统计学意义(P>0.05).1例发生远期下尺桡关节不稳。
结论：对桡骨远端骨折合并下尺桡关节不稳定采用锁定钢板固定系统治疗桡骨远端骨折的同时，固定与不固定下尺桡关节临床效果无差异，因此对于合并下尺桡关节不稳的桡骨远端骨折，若桡骨远端骨折能获得满意的解剖复位，不推荐Ⅰ期固定下尺桡关节。 |
| 【关键词】桡骨骨折 关节不稳定性 骨折固定术，内 病例对照研究 |
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| A case control study on the treatment of distal radioulnar joint instability combined with distal radius fractures between fixation and non-fixation distal radioulnar joint |
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ABSTRACT
Objective: To explore the options on treatment of distal radioulnar joint instability combined with distal radius fracture.
Methods: From June 2007 to December 2009, 264 patients with unstable distal radius fractures were treated with open reduction and internal fixation, in which 42 patients combined with distal radioulnar instability. Distal radioulnar joints of 20 patients were fixed with Kirschner wire or plaster cast at supinator position, and other distal radioulnar joints of 22 patients were not fixed. Range of motion of wrist joints and grip strength were observed;function of wrist were evaluated by modified Gartland-Werley scoring system (GW score);stability of distal radioulnar joints were tested at final follow-up.
Results: Forty-one patients were followed up more than 1 year. All fractures obtained healing within 3 months after operation, and apposition of joints was good, no significant subluxation or dislocation were found. There were not statistical differences in grip strength, motion of joints and GW score between two groups (fixation and non-fixation). Only one patient occurred chronic distal radioulnar instability.
Conclusion: There was no significant difference between fixation and non fixation for the treatment of distal radius fractures with distal radioulnar joint instability. For this reason, if fractures can be satisfactory reduced, there is no need for the one-stage distal radioulnar joint fixation. |
| KEY WORDS Radius fractures Joint instability Fracture fixation, internal Case-control studies |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 刘杰,李少华,蔡郑东,李振华,王建广,张磊,余磊.不固定下尺桡关节治疗桡骨远端骨折合并下尺桡关节不稳定的病例对照研究[J].中国骨伤,2011,24(11):890~893 |
| 英文格式: | LIU Jie,LI Shao-hua,CAI Zheng-dong,LI Zhen-hua,WANG Jian-guang,ZHANG Lei,YU Lei.A case control study on the treatment of distal radioulnar joint instability combined with distal radius fractures between fixation and non-fixation distal radioulnar joint[J].zhongguo gu shang / China J Orthop Trauma ,2011,24(11):890~893 |
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