腕关节镜评估不稳定型桡骨远端骨折患者TFCC损伤的发生率

Wrist arthroscopy for evaluating the incidence of TFCC lesions in patients with unstable distal radius fractures

目的 应用腕关节镜辅助复位不稳定型桡骨远端骨折,统计TFCC损伤的发生率。对Pamlar ⅠB型损伤进行镜下修复。方法 收集自2014年至2017年在我院行桡骨远端骨折切开复位内固定并应用腕关节镜辅助复位的病例,共92例。根据Palmar分型记录TFCC损伤的类型。在骨折切开复位内固定之后,对Palmar ⅠB型TFCC损伤进行镜下修复。结果 92例桡骨远端骨折的病例中有81例合并TFCC损伤,占88.0%。其中Palmar ⅠA型损伤占TFCC损伤的13.6%(11/81),ⅠB型占35.8%(29/81),ⅠC型占12%(1/81),ⅠD型占29.6%(24/81),同时存在两种类型以上损伤的占19.8%(16/81)。结论 不稳定型桡骨远端骨折伴随着较高的TFCC损伤发生率;腕关节镜可以辅助桡骨远端关节内骨折复位,同时对Palmar ⅠB型损伤进行镜下修复。

Objective To evaluate the incidence of TFCC lesions associated with unstable distal radius fractures and repair Palmar type ⅠB lesion under arthroscopy which assisted the fracture reduction.Methods A total of92patients with distal radius fractures were included who underwent open reduction internal fixation(ORIF)and wrist arthroscopy assisted reduction from2014to2017in our hospital.According to Palmar classification,the type of TFCC lesions was recorded.After fracture ORIF,Palmar type ⅠB TFCC lesion was repaired under arthroscopy.Results Among the92cases of distal radius fractures, 81cases had TFCC lesions,accounting for88%.Palmar type ⅠA lesion accounted for13.6%(11/81), type ⅠB lesion35.8%(29/81),type ⅠC lesion1.2%(1/81),type ⅠD lesion29.6%(24/81)and more than two types of lesion19.8%(16/81).Conclusion The incidence of TFCC lesions associated with unstable distal radius fractures was high.Wrist arthroscopy can assist in the reduction of intra-articular fractures of the distal radius and repair Palmar type Ⅰ B lesion.