桡骨远端骨折合并腕部尺神经损伤的诊断与治疗

Diagnosis and treatment of distal radius fracture combined with ulnar nerve injury at the wrist

目的总结桡骨远端骨折合并腕部尺神经损伤的发病机制、临床表现和治疗方法。方法对桡骨远端骨折合并尺神经支配区单纯掌侧感觉、运动或感觉和运动同时改变的7例患者,进行腕尺管探查尺神经松解术。结果术后随访时间为6～12个月,按中华医学会手外科学会上肢部分功能评定试用标准评定:优5例,良1例,可1例。结论部分伸直型桡骨远端骨折可合并腕部尺神经卡压,一经明确诊断即应早期行尺神经松解手术。

Objective To summarize the pathogenesis, clinical manifestation and treatment of distal radius fracture combined with ulnar nerve injury at the wrist. Methods Seven patients with distal radius fracture combined with neurolngic symptoms of the ulnar nerve at wrist were treated. The symptoms included numbness of the ulnar side of the palm, the volar side of the little finger and ulnar half of the ring finger; weakness or/and atrophy of the intrinsic muscles and claw hand deformity; or changes of sensation and movement at the same time. Results The cases were followed-up for 6 to 12 months. According to the criteria of functional evaluation of the upper limb issued by the Hand Surgery Society of Chinese Medical Association, 5 cases were graded as excellent, 1 case as good, and 1 case as fair. Conclusion Ulnar nerve compression at the wrist can occur in some cases of distal radius fractures. Early operation should be given to those cases with definite diagnosis.