超声判断桡尺远侧关节稳定性对盖氏骨折治疗的临床意义分析

Analysis of the clinical significance of ultrasonic determination of the stability of the distal radioulnar joint in the treatment of Galeazzi fractures

目的探讨在盖氏骨折治疗中应用超声检查判断桡尺远侧关节稳定性的可靠性和临床意义。方法自2014年1月到2016年12月，我们共收治11例盖氏骨折患者，根据超声检查桡尺韧带连续性结果作为依据，将术中应力试验结果作为治疗参考标准，以此决定桡尺远侧关节的固定方式。术后对骨折愈合和腕关节功能进行随访分析。结果超声结果判断桡尺远侧关节稳定性的敏感性为87．5％，特异性为66．7％。术后随访时间为3~12个月，平均7．2个月。所有患者均在3个月随访时达到骨折愈合，桡尺远侧关节对合关系良好，无半脱位或脱位再发生。采用Mayo腕关节功能评分评价：优7例，良3例，可1例，功能恢复较为满意。结论对于盖氏骨折中桡尺远侧关节稳定性的判断，超声检查是一项价廉、高效的检查方式，也利于我们在术中结合应力试验对桡尺远侧关节作出更适合的处理。

Objective To investigate the reliability and clinical significance of ultrasonography in the diagnosis of distal radioulnar joint （DRUJ） in the treatment of Galeazzi fractures. Methods From January 2014 to December 2016, 11 cases of Galeazzi fractures were treated. According to the continuous results of the examination of the radioulnar ligament by ultrasonography, the results of the intraoperative stress test were used as the reference standard to determine the fixation method of DRUJ. Postoperatively fracture healing and wrist function scores were evaluated and analyzed. Results The sensitivity of the ultrasonography determining the stability of DRUJ was 87.5% and the specificity was 66.7%. The postoperative follow-up time was 3 to 12 months, with an average of 7.2 months. All the cases achieved fracture healing at 3 months of follow-up. No recurrent subluxation or dislocation occurred in DRUJ. According to Mayo wrist function score, the results were excellent in 7 cases, good in 3 cases and fair in 1 case. The functional recovery was satisfactory. Conclusion For the judgment of the stability of DRUJ in Galeazzi fractures, ultrasonography is a cheap and efficient method. It is also helpful for surgeons to make more suitable treatment for DRUJ during the operation combined with stress test.