桡骨远端骨折后下尺桡关节不稳的原因浅析

Reasons Analysis on Unstable Distal Radioulner Joint after Radius Distal Fracture

[目的]探讨桡骨远端骨折后影响下尺桡关节稳定性的原因。[方法]62例桡骨远端骨折患者均采用手法复位石膏或夹板外固定治疗,骨折临床愈合后去除外固定后进行功能锻炼,摄腕关节正侧位片,检查下尺桡关节稳定性,并采用Gartland—Werley评分系统(GW评分)对腕关节功能进行评估。[结果]62例均获得4～7个月随访,平均5.8个月。l9例有下尺桡关节不稳定。该19例患者GW评分平均为(l2.20±5.82),稳定的43例患者GW评分平均为(6.71±4.31),差异有统计学意义(P<0.05)。[结论]尺骨茎突骨折分离明显或不愈合、桡骨短缩畸形≥5mm、三角纤维软骨复合体损伤是造成下尺桡关节不稳,影响腕部功能的主要原因。

[Objective] To observe the reason of unstable distal radioulnar joint after radius distal fracture.[Method] 62 cases took manipulation reposition with outer fixation of gypsum or splint;after clinical cure,remove outer fixation for functional exercise,then test distal radioulnar joint stability;take Sarmiento-improved Gartland—Werley Score（GW） for wrist function evaluation.[Result] After average follow-up for 5.8m,19 cases had unstable distal radioulnar joint with the patients GW score（l2.20±5.82）,but（6.71±4.31） for those stable cases,the difference had statistical meaning.[Conclusion] Ulna belonoid fracture having marked separation or being not cured,or radius cripetura≥5mm,or 3-angle fibrocartilage complex injury are the causes of unstable distal radioulnar joint,influencing wrist function.