泪滴角在桡骨远端中间柱骨折治疗中的应用

Application of teardrop angle in the treatment of distal radius middle column fractures

目的 探讨泪滴角(TDA)在桡骨远端中间柱骨折治疗中的应用。方法 将37例采用切开复位钢板内固定治疗的桡骨远端中间柱骨折患者根据术后TDA大小分为TDA≥50°组(27例)和TDA<50°组(10例)。记录骨折愈合情况、术后并发症发生情况、疼痛VAS评分、腕关节及前臂活动度,采用Gartland-Werley评分评价腕关节功能恢复情况。结果 患者均获得随访,时间8~16个月。骨痂生成和骨折愈合时间两组比较差异均无统计学意义(P>0.05)。无内固定物松动、移位、断裂及骨折移位、肌腱损伤等并发症发生。末次随访时,疼痛VAS评分、前臂旋转活动度及腕关节功能优良率TDA≥50°组均优于TDA<50°组(P<0.05);腕关节活动度两组比较差异无统计学意义(P>0.05)。结论 手术治疗桡骨远端中间柱骨折,术中应尽量恢复TDA,可以更好地缓解疼痛、改善腕关节功能。

Objective To investigate the clinical effect of teardrop angle(TDA)in the treatment of distal radius middle column fracture.Methods According to the postoperative measurement value of TDA,37 patients with distal radius middle column fracture were divided into TDA≥50°group(27 cases)and TDA<50°(10 cases).The postoperative status of fracture healing,postoperative complications,pain VAS,wrist joint and forearm range of motion were recorded,and the Gartland-Werley score was used to evaluate wrist joint functional recovery.Results All patients were followed up for 8~16 months.There was no statistical difference in callus formation and fracture healing time between the two groups(P>0.05).All patients had no internal fixation loosening,displacement,breakage,fracture displacement,tendon injury and other postoperative complications after surgery.At the last follow-up,the pain VAS,forearm rotational range of motion,excellent-good rate of the wrist function in the TDA≥50°group were all better than those in the TDA<50°group(P<0.05).There was no statistical difference in wrist activity range between the two groups(P>0.05).Conclusions In surgical treatment of distal radius middle column fractures,TDA should be restored during surgery as much as possible,which can better relieve postoperative pain,and improve postoperative wrist joint function.