尺骨茎突骨折对小切口复位外固定架固定术治疗桡骨远端骨折疗效的影响

The effects of ulnar styloid fractures on the curative effect of small incision reduction and external fixation for distal radius fractures

目的探讨尺骨茎突骨折对小切口复位外固定架固定术治疗桡骨远端骨折(DRF)疗效的影响。方法选我院收治的90例行手术治疗的不稳定性DRF患者,依据患者是否合并尺骨茎突骨折及其类型分为A组尺骨茎突体部和尖端骨折,B组尺骨茎突基底部骨折,C组未发生尺骨茎突骨折,三组均采用小切口复位外固定架固定术治疗,对比三组术后骨折愈合时间、手术疗效、影像学指标、腕关节活动度和术后并发症发生率。结果三组经手术治疗后的优良率分别为92.00%、96.30%和92.11%,三组术后骨折愈合时间、手术治疗优良率、影像学指标(桡骨远端掌倾角、尺偏角、桡骨高度)、腕关节活动度(掌屈、背伸、尺偏、桡偏、旋前、旋后)和术后并发症发生率比较差异均无统计学意义(P>0.05)。结论小切口复位外固定架固定术治疗桡骨远端骨折的疗效较好,患者是否出现尺骨茎突骨折对手术治疗后腕关节功能恢复及术后并发症的发生没有明显影响;但对于出现尺骨茎突基底部骨折时,术中可检查下尺桡关节的稳定性,若不稳定可进行手术固定处理。

Objective To explore the effects of ulnar styloid fractures on the curative effect of small incision reduction and external fixation for distal radius fractures(DRF).Methods Ninety patients with unstable DRF who underwent surgical treatment in our hospital were enrolled as study objects.Their clinical and follow-up data were retrospectively analyzed.According to presence or absence of ulnar styloid fractures and their types,they were divided into group A(ulnar styloid fractures at body and tip sites),group B(ulnar styloid fractures at base site)and group C(without ulnar styloid fractures).All three groups were treated with small incision reduction combined with external fixation.The healing time of postoperative fractures,surgical curative effect,imaging indexes,wrist range of motion(ROM)and incidence of postoperative complications were compared among the three groups.Results After surgical treatment,good rates in the three groups were 92.00%,96.30%and 92.11%,respectively.There were no significant differences in healing time of postoperative fracture,good rate of surgical treatment,imaging indexes such as palm tilt of distal radius,ulnar deviation angle and radius height,wrist ROM such as palm flexion,dorsiflexion,ulnar deviation,radial deviation,pronation and supination and incidence of postoperative complications among the three groups(P>0.05).Conclusion The curative effect of small incision reduction and external fixation for DRF is good.There are no significant effects of ulnar styloid fractures on postoperative recovery of wrist function and occurrence of postoperative complications.When there are ulnar styloid fractures at base site,stability of lower ulnar radial joints can be checked during surgery.If they are unstable,surgical fixation should be performed.