空心螺钉固定治疗HauckⅡ型尺骨茎突骨折

Cannulated screws for the treatment of Hauck type Ⅱ ulnar styloid process fracture

目的探讨空心螺钉固定治疗HauckⅡ型的尺骨茎突骨折的应用价值。方法回顾性分析2020年12月至2023年2月在厦门大学附属福州第二医院治疗的HauckⅡ型尺骨茎突骨折患者93例的临床资料进行病例对照研究, 其中未行手术固定患者38例, 行手术固定患者55例, 手术患者中行空心螺钉固定27例, 双克氏针固定28例, 比较各组患者的骨折愈合情况, 术后康复治疗情况及腕关节功能恢复情况。结果手术固定组的骨折愈合率和下尺桡关节松弛发生率分别为100.00%(55/55)、5.45%(3/55), 均明显优于非手术固定组的57.89%(22/38)、50.00%(19/38), 手术固定组的腕关节功能评分明显优于非手术固定组, 差异均有统计学意义(χ^(2)=27.66、24.69, Z=-5.18, 均P<0.001);空心螺钉组与双克氏针组的手术时间及术中出血量差异均无统计学意义[(21.41±5.15)min比(20.93±5.71)min, (2.11±0.97)mL比(2.07±0.90)mL, t=0.32、0.15, 均P>0.05], 空心螺钉组的骨折愈合时间及康复介入时间均短于双克氏针组[(6.48±1.05)周比(9.14±1.24)周, (2.11±0.32)周比(3.11±0.57)周, t=8.57、7.98, 均P<0.001];空心螺钉组的术后腕关节功能评分优于双克氏针组(Z=-2.21, P<0.05)。结论对于HauckⅡ型尺骨茎突骨折的患者, 手术固定可以促进患者术后腕关节功能恢复, 而空心螺钉固定是治疗HauckⅡ型的尺骨茎突骨折的有效方法。

Objective To investigate the application value of cannulated screws in the treatment of Hauck typeⅡulnar styloid process fracture.Methods The clinical data of 93 patients with Hauck typeⅡulnar styloid process fracture who received treatment at Fuzhou Second Hospital Affiliated to Xiamen University from December 2020 to February 2023 were retrospectively analyzed for a case-control study.Among these patients,38 patients did not undergo surgical fixation and 55 patients underwent surgical fixation.Twenty-seven patients underwent surgical fixation with cannulated screws and twenty-eight patients underwent surgical fixation with Kirschner wires.The fracture healing,postoperative rehabilitation,and functional recovery of the wrist were compared among groups.Results The fracture healing rate and the incidence of distal radioulnar joint instability in the surgical fixation group were 100.00%(55/55)and 5.45%(3/55),respectively.These were significantly higher and lower respectively compared with the non-surgical fixation group[57.89%(22/38),50.00%(19/38),χ^(2)=27.66,24.69,both P<0.001].The wrist function recovery in the surgical fixation group was significantly superior to that in the non-surgical fixation group(Z=-5.18,P<0.001).There were no statistically significant differences in operative time and intraoperative blood loss between the cannulated screw group and the Kirschner wire group[(21.41±5.15)minutes vs.(20.93±5.71)minutes,(2.11±0.97)mL vs.(2.07±0.90)mL,t=0.32,0.15,both P>0.05].The fracture healing time and rehabilitation intervention time in the cannulated screw group were shorter than those in the Kirschner wire group[(6.48±1.05)weeks vs.(9.14±1.24)weeks,(2.11±0.32)weeks vs.(3.11±0.57)weeks,t=8.57,7.98,both P<0.001].The postoperative wrist function scores in the cannulated screw group were superior to those in the Kirschner wire group(Z=-2.21,P<0.05).Conclusion For patients with Hauck typeⅡulnar styloid process fracture,surgical fixation can promote the recovery of wrist function after surgery,and cannulated screw fixation is an effective method for the treatment of Hauck typeⅡulnar styloid process fracture.