CAJ | 학술논문

目的探讨腕关节镜监视下治疗尺骨茎突骨折的方法,以获得更好的治疗效果.方法对15例尺骨茎突骨折的患者,在C臂透视机及腕关节镜监视下先将合并的桡骨远端骨折进行复位,经皮穿针内固定或切开复位钢板内固定,然后在腕关节镜下检查三角纤维软骨复合体(triangular fibrocartilage complex,TFCC)是否损伤,并作修整、清理等相应的处理,在关节镜监视下将尺骨茎突骨折复位,经皮作钢丝张力带内固定.结果 11例合并有TFCC损伤,经平均15.4个月的临床随访,X线片检查显示尺骨茎突骨折全部骨性愈合,骨性愈合时间平均5.2个月.按照Green-O'Brien功能评定方法进行腕关节功能评定,优良率为93.3%,无腕关节尺侧疼痛及腕关节不稳等并发症发生.结论腕关节镜下治疗尺骨茎突骨折既可以对骨折进行有效的复位及固定,有利于骨折的愈合;又可以了解腕关节内TFCC等结构的损伤程度,便于早期处理,以免遗留慢性腕痛或腕关节不稳定.
목적 탐토완관절경감시하치료척골경돌골절적방법,이획득경호적치료효과.방법 대15례척골경돌골절적환자,재C비투시궤급완관절경감시하선장합병적뇨골원단골절진행복위,경피천침내고정혹절개복위강판내고정,연후재완관절경하검사삼각섬유연골복합체(triangular fibrocartilage complex,TFCC)시부손상,병작수정、청리등상응적처리,재관절경감시하장척골경돌골절복위,경피작강사장력대내고정.결과 11례합병유TFCC손상,경평균15.4개월적림상수방,X선편검사현시척골경돌골절전부골성유합,골성유합시간평균5.2개월.안조Green-O'Brien공능평정방법진행완관절공능평정,우량솔위93.3%,무완관절척측동통급완관절불은등병발증발생.결론 완관절경하치료척골경돌골절기가이대골절진행유효적복위급고정,유리우골절적유합;우가이료해완관절내TFCC등결구적손상정도,편우조기처리,이면유류만성완통혹완관절불은정.
Objective To discuss the treatment methods of wrist arthroscopic management for fractures of the ulna styloid process to achieve better clinical outcomes. Methods Fifteen cases of fractures of the ulna styloid process were first treated with reduction of combined fracture of the distal radius under C-arm fluoroscope and wrist arthroscope monitoring using percutaneous pinning fixation or open reduction and internal fixation with plate and screws. The triangular fibrocartilage complex (TFCC) was examined under wrist arthroscope and debridement or repair was done accordingly. The fractured ulna styloid process was reduced and fixed with steel tension band under wrist arthroscope monitoring. Results Eleven cases had concomitant TFCC injury. The patients were follow-up for an average of 15.4 months and the X-ray showed bone union of all the ulna styloid process fractures. The mean healing time was 5.2 months. According to the Green-O' Brien functional evaluation criteria the excellent and good rate of wrist function was 93.3%. There were no complications such as ulnar side pain and wrist instability. Conclusion Wrist arthroscopic treatment of fractures of ulna styloid process is not only effective to reduce and fix the fracture and beneficial for fracture heeling, but also able to detect TFCC injury for early management to avoid chronic wrist pain or wrist instability.