9例盖氏骨折术后骨不连合并下尺桡关节炎的疗效分析

Clinical Efficacy of 9 cases of Radius Nonunion and Arthritis of the Distal Radioulnar Joint after Galeazzi Fracture Surgery

目的:探讨手术治疗盖氐骨折术后骨不连合并下尺桡关节炎的方法和临床疗效。方法:对2010年1月至2015年6月收治的9例盖氐骨折术后骨不连合并下尺桡关节炎患者的临床资料进行回顾性分析,评价其骨不连愈合率、前臂旋转活动度,采用DASH问卷评估上肢功能,记录术中及术后并发症的发生情况。结果:9例患者随访13-78个月,平均45.4个月所有骨不连在24周都获得愈合,愈合时间12-24周;术后前臂旋转功能平均115.56±26.74°,显著高于术前(P<0.01);而DASH评分从术前48.56±8.71分降至20.11±8.08分(P<0.05);根据Anderson前臂功能评分标准,优2例,良5例,中2例,优良率为77.8%所有患者均对手术效果十分满意。结论:尺骨头切除术联合桡骨切开植骨内固定术操作简单有效,可显著改善盖氐骨折术后骨不连合并下尺桡关节炎患者的上肢功能。

Objective：To investigate the clinical efficacy and treatment of radius nonunion and Arthritis of the Distal Radioulnar Joint（DRUJ） after Galeazzi fracture surgery.Methods：We retrospectively analyzed the clinical data of 9 cases with radius nonunion and Arthritis of the DRUJ after Galeazzi fracture who were treated in our department from January 2010 to June 2015.Follow-up included bone union rate,forearm active range of motion（AROM）,the Disabilities of the Arm,Shoulder and Hand（DASH） questionnaire,intra-operative and postoperative complications.Results：we reviewed all patients at an average 45.4 months（range,13to78 months） after surgery;Bony union was achieved between 12 and 24 weeks after operation;The AROM of the treated forearm averaged 115.56±26.74° for pronation and supination,which significantly better than preoperative（P〈0.01）;The mean DASH score decreased from48.56±8.71 to 20.11±8.08 postoperatively（P〈0.05）;According to the criteria of Anderson et al,there were excellent in 2 cases,good in 5,fair in 2,the excellent and good rate was 77.8%;Overall,patient satisfaction was high and 9 patients（100%） would choose to undergo the operation again.Conclusion：This study demonstrated that ulnar head resection plus combining an autograft with a plate for radius nonunion appears to be a technically easy and reliable procedure,and yield good upper limb functional outcome for the patients of radius nonunion and arthritis of the distal radioulnar joint after galeazzi fracture.