尺骨茎突骨折及其分型对桡骨远端骨折术后疗效的影响

Effect of ulnar styloid fracture on postoperative outcome of distal radius fracture

目的 探讨尺骨茎突骨折与否及其分型对桡骨远端骨折手术的影响。方法 2020年1月~2021年12月在本院治疗的桡骨远端骨折病人92例,根据病人是否合并尺骨茎突骨折以及骨折的Hauck分型标准将其分为非合并组(48例)、合并Ⅰ型组(21例)和合并Ⅱ型组(23例)。收集病人术前、术后6个月和术后1年的掌倾角、尺偏角、桡骨茎突高度恢复等影像学数据及Gartland-Werly评分、握力、臂肩手功能障碍(disabilities of the arm,shoulder and hand,DASH)评分,比较3组的并发症发生率。结果 3组病人术前掌倾角、尺偏角、桡骨茎突高度和关节面平整度差异无统计学意义(P>0.05),3组病人术后6个月及1年掌倾角、尺偏角、桡骨茎突高度和关节面平整度均有不同程度改善,差异有统计学意义(P<0.05),除术后6个月3组的掌倾角、尺偏角存在差异,其余影像学参数术后6个月及1年差异无统计学意义(P>0.05)。3组病人的术后6个月和1年的Gartland-Werly评分比较差异无统计学意义(P>0.05);3组病人术前握力和DASH评分比较差异无统计学意义(P>0.05),术后6个月及1年,3组病人的握力和DASH评分均有不同程度改善,差异有统计学意义(P<0.05),术后1年,与非合并组和合并Ⅰ型组比,合并Ⅱ型组病人的握力和DASH评分恢复较慢,差异有统计学意义(P<0.05)。3组病人均未发生明显的并发症。结论 合并Ⅱ型尺骨茎突骨折会影响桡骨远端骨折术后疗效,合并Ⅰ型尺骨茎突骨折对腕功能影响较小。

Objective To investigate the effect of ulnar styloid fracture and its type on distal radius fracture surgery.Methods A total of 92 patients with distal radius fracture were randomly selected in our hospital from January 2020 to December 2021.According to whether the patients were combined with ulnar styloid fracture and the Hauck classification criteria of fracture,they were divided into non-combined group(n=48),type Ⅰ group(n=21) and type Ⅱ group(n=23).The palmar angle,ulnar declination,height recovery of radial styloid,Gartland-Werly score,grip strength and DASH score preoperative,6 months and 1 year after surgery in 3 groups were collected and compared.The complication in 3 groups were compared.Results Before operation,there was no statistically significant difference in the palm angle,ulnar deviation angle,radius styloid process height and joint surface flatness in 3 groups(P>0.05).6 months and 1 year after operation,the palm angle,ulnar deviation angle,radius styloid process height and joint surface flatness in 3 groups were improved(P<0.05).Except for the palm angle and ulnar deviation angle in 3 groups at 6 months after operation,there was no statistically significant difference in the other imaging parameters at 6 months and 1 year after operation(P>0.05).There was no significant difference in the Gartland-Welly score in 3 groups at 6 months and 1 year after operation(P>0.05).Before operation,there was no significant difference in grip strength and DASH score among in 3 groups(P<0.05).6 months and 1 year after operation,the grip strength and DASH score of in 3 groups were improved(P<0.05).No obvious complications occurred in 3 groups.Conclusion Type Ⅱ styloid fracture can affect the postoperative effect of distal radius fracture,while type Ⅰ styloid fracture has little effect on wrist function.