累及桡尺远侧关节不稳定的尺骨茎突骨折手术治疗

Surgical tretment of ulnar styloid fractures associated with DRUJ instability

目的介绍累及桡尺远侧关节不稳定的桡骨远端合并尺骨茎突骨折的手术指征和治疗方法。方法2005年1月至2009年6月，对12例桡骨远端骨折合并尺骨茎突骨折的患者，采用克氏针结合张力带钢丝固定尺骨茎突，同时采用骨锚修复下尺桡韧带深层结构在尺骨隐窝的止点，从而稳定桡尺远侧关节。结果术后12例桡骨远端骨折及尺骨茎突骨折均愈合，术后随访时间为6，18个月。按改良的Mayo腕关节评分标准评定：优4例，良5例，中2例，差1例。结论尺骨茎突在桡尺远侧关节稳定中起着重要作用，对累及下尺桡韧带结构损伤的尺骨茎突骨折进行固定并重建韧带对稳定桡尺远侧关节有较为重要的作用。

Objective To introduce the surgical indications and treatment options of combined distal radial and ulnar styloid fractures associated with DRUJ instability. Methods Twelve patients suffering from combined distal radial and ulnar styloid fractures were treated between January 2005 and June 2009. The ulnar styloid was fixed by a Kirschner wire and tension band. Meanwhile the DRUJ was stabilized by anchoring the deep structure of the radioulnar ligament to the ulnar fossa. Results The dttmtion of postoperative follow-up ranged from 6 to 18 months. Bone union of the distal radius and ulnar styloid was achieved in all 12 cases. According to modified Mayo wrist score, the results were excellent in 4 cases, good in 5 cases, moderate in 2 eases and bad in 1 case. Conclusion Ulnar styloid plays an important role in DRUJ stability. Fixation of ulnar styloid fracture that affects the radioulnar ligament and repairing the deep radioulnar fibers is critical for stabilizing the DRUJ.