尺骨茎突骨折对桡骨远端骨折内固定术后腕关节功能的影响

Effect of an associated ulnar styloid fracture on the wrist function after internal fixation of the distal radius fracture

目的探讨尺骨茎突骨折对挠骨远端骨折内固定术后腕关节功能的影响.方法回顾性分析2 0 1 2 年1 月至1 2 月行切开复位内固定的1 8 9 例挠骨远端骨折患者资料,根据是否伴有尺骨茎突骨折分为不伴尺骨茎突骨折组（6 1 例）和伴尺骨茎突骨折组（1 2 8 例）.根据患者影像学资料及末次随访G a rtk n d -W e rle y腕关节评分、臂肩手功能障碍（D A SH ）评分、腕关节活动度（背伸、掌屈、挠偏、尺偏）、握力和腕关节尺侧旋转疼痛发生率评定腕关节功能.结果所有患者随访3 0 ？4 6 个月,平均3 8 个月.两组挠骨远端骨折愈合时间、掌倾角、尺偏角和挠骨高度无统计学差异（P 〉 0. 0 5 ）,且末次随访时握力、腕关节主动活动度、G a rtk n d -W e rle y腕关节评分和D A S H 评分无统计学差异（_P 〉 0. 05） .两组术后尺侧旋转疼痛发生率亦无统计学差异（P 〉 0 .0 5 ） .结论尺骨茎突骨折不影响挠骨远端骨折内固定患者术后腕关节功能.

Objective To investigate the effect of an associated ulnar styloid fracture on the wrist function after internal fixation of the distal radius fracture.Methods From January 2012 to December 2012,189 patients with distal radius fractures were treated by open reduction and internal fixation.These cases could be divided into 2 groups:distal radius fracture without(61 cases)or with associated ulnar styloid fracture(128 cases).Postoperative evaluation included the Gartland-Werley and disabilites of the arm,should and hand(DASH)scores,range of wrist motion(extension,flexion,radial and ulnar inclination),grip strength and an incidence of ulnar-sided wrist pain.Results The mean follow-up was 38 months(range,30-46 months).There were no differences between the two groups in bone union time,palmar inclination angle,ulnar inclination angle,radius height,the Gartland-Werley and DASH scores,range of wrist motion,grip strength and the incidence of ulnar-sided wrist pain at the final follow-up(P>0.05).Conclusion An associated ulnar styloid fracture has no adverse effect on the wrist function after internal fixation of the distal radius fracture.