Colles骨折与腕关节不稳定

Colles fracture and instability of wrist joint

本文作者对５１例Ｃｏｌｌｅｓ骨折患者进行了３～６年的随访。其中有２０例Ｘ线表现为腕关节背侧半脱位。作者对单纯Ｃｏｌｌｅｓ骨折者与Ｃｏｌｌｅｓ骨折合并腕关节背侧半脱优者的远期疗效进行了分析比较。发现前者功能明显优于后者。说明腕关节背侧半脱位对患者远期功能的恢复具有非常重要和直接的作用。作者认为腕关节背侧半脱位好发于严重移位骨折和高能量损伤或伴有舟月分离者。对Ｃｏｌｌｅｓ骨折合并腕关节背侧半脱位者，闭合复位应力求恢复掌倾角，腕关节宜固定在中立位或轻度背伸位。

Abstractwe reviewed 51 cases of colles fracture patientswith 3～6years follow-up and found 20 cases had dor-sal carpal subluxatin(DCS)in this group. Long termresults were analysed and compared between the sim-ple Colles fracture and the Colies fracture with DCS.Itwas shown that the remote function of the wrist in thesimple CoIles fracture was much more satisfactory thanin that with DCS.That indicated the DCS is a very im-portant factor to the late results of the wrist afterColles fracture. The authors pointed out that the DCSoccurs frequently in the severely displaced type causedby high energy force and in the fracture associated withscapholunate dissociation. During the close reductionof the Colles fracture associated with DCS,correctionof the palmar angulation and decrease of the angle ofpalmar tilt should be required,as well as the neutral orlight dorsal flexion fixation of the wrist after reduc-tion.