Colles骨折X线征象及临床意义

The X-ray Manifestation of Colles' Fracture and its Implications

目的:分析Colles骨折X线表现及临床意义。方法:对128例Colles骨折患者腕关节正侧位X线片上掌倾角、尺偏角、桡骨短缩和远侧桡尺关节间隙等进行测量分析并根据Frykman方法分型。结果:(1)Frykman分型:Ⅰ型27例(21.1%),Ⅱ型30例(23.4%),Ⅲ型15例(11.7%),Ⅳ型17例(13.3%),Ⅴ型13例(10.2%),Ⅵ型12例(9.4%),Ⅶ型9例(7.0%),Ⅷ型5例(3.9%);(2)掌倾角均数为-8.94°,107例(83.6%)患者掌倾角变为负角,Ⅶ、Ⅷ型全部成负角,Ⅷ型变化最大-20.97°;(3)尺偏角变小,均数为14.54°,Ⅷ型最小10.74°;(4)各分型均有桡骨短缩,2mm以上86例(67.2%),Ⅶ、Ⅷ型短缩全部超过2mm;(5)远侧桡尺关节间隙分离2mm以上24例(18.75%),Ⅷ型分离最大2.46mm;(6)64例(50%)伴尺骨茎突骨折。结论:Colles骨折X线检查对判断骨折分型及损伤程度提供了依据,对临床分型和治疗有指导意义。

Objective：To analyze the X-ray manifestation of Colles＇ fracture and to probe its implications. Methods：The X-ray parameters （including palm tilting angle,ulnar deviation angle,the loss of radius length and distal radioulnar joint space） of wrist were measured and classified according to the Frykman classification system in 128 Colles＇ fracture patients. Results：（1） Of all the fractures,27 （21.1%） were classified as type Ⅰ,30 （23.4%） as type Ⅱ,15 （11.7%） as type Ⅲ,17 （13.3%） as type Ⅳ,13 （10.2%） as type Ⅴ,12 （9.4%） as type Ⅵ,and 9 （7.0%） as type Ⅶ,and 5 （3.9%） as type Ⅷ. （2） The mean palm tilting angle was -8.94°. One hundred and seven cases （83.6%） changed to negative angle,type Ⅶ and Ⅷ all changed to negative angle type Ⅷ changing to the maximum —20.97°; （3） Ulnar deviation angle became smaller and the mean was 14.54°,with type Ⅷ possessing the minimum 10.74°; （4） There was loss of radius length in all types of fractures. The loss exceeded 2mm in 86 cases （67.2%） and also in all type Ⅶ and Ⅷ fractures; （5） The space of distal radioulnar joint separated more than 2 mm in 24 cases （18.75%）,with the maximum 2.46mm in type Ⅷ fracture; （6） Sixty-four cases （50%） were accompanied with fracture of processus styloideus ulnae. Conclusion：The X-ray examination of Colles＇ fracture provides a basis for classification and degree of injury,which has guidance significance on classification and treatment.