桡骨远端骨折影像学测量指标与近期疗效的关系

The relationship between radiographic measurement and short-term clinical outcome of distal radius fractures

目的通过对桡骨远端骨折患者的影像学测量，分析各影像学参数和近期疗效之间的关系。方法对62例桡骨远端骨折闭合复位石膏外固定的患者，利用StarPACS影像系统进行测量，并记录所有患者X线片的桡骨高、掌倾角及尺偏角的情况，并分析影像学测量指标与自测腕关节功能之间的关系。结果62例桡骨远端骨折中，有50例（占80．6％）经保守治疗后效果优良。当桡骨高大于6．0mm，掌倾角大于5°，尺偏角大于18°时，自测腕关节功能优良率较高。影像学指标和自测腕关节功能的相关性桡骨高〉掌倾角〉尺偏角。结论桡骨高、掌倾角及尺偏角等可以作为桡骨远端骨折治疗效果评估的影像学指标，手法复位后影像学不达标者应当重新复位或采用手术治疗，桡骨远端骨折时应当首先考虑桡骨高的恢复。

Objective To evaluate the relationship between radiographic measurement and short-term clinical outcome of distal radius fractures. Methods Sixty-two cases of distal radius fractures treated with closed reduction and cast immobilization were involved in the study. The X-ray films were measured in the StarPACS system to acquire radial shortening, palmar tilt and radial inclination. The relationship between radiographic measurements and short-term wrist joint function was analyzed. Results Fifty out of 62 （ 80.6% ） cases achieved good results. Better wrist joint function was observed when radial shortening was greater than 6.0 mm, palmar tilt greater than 5° and radial inclination greater than 18°, The correlation between radiographic measurement and wrist function was tightest for radius shortening, followed by palmar tilt and radial inclination, Conclusion Radial shortening, palmar tilt and radial inclination can be used as radiographic criteria for evaluating results in the treatment of distal radius fractures. If these criteria are not met after manual reduction, re-manipulation or surgical intervention should be considered. Correction of radial shortening should be the priority in the management of distal radius fractures.