中华手外科杂志
中華手外科雜誌
중화수외과잡지
CHINESE JOURNAL OF HAND SURGERY
2014年
5期
330-332
,共3页
王树%王加宽%顾加祥%荆鑫
王樹%王加寬%顧加祥%荊鑫
왕수%왕가관%고가상%형흠
桡骨骨折%腕关节%形态学
橈骨骨摺%腕關節%形態學
뇨골골절%완관절%형태학
Radius fractures%Carpal joints%Morphology
目的 探讨桡骨远端骨折治疗后桡腕关节形态学特征与腕关节功能的相关性.方法 收集自2006年1月至2013年12月行闭合复位外固定支架结合克氏针有限内固定及切开复位钢板螺钉内固定两种方法治疗的C型桡骨远端骨折病例共388例,采用Dienst功能评分、X线片及CT片评价腕关节功能.结果 Dienst功能评分,恢复桡骨高度及恢复桡腕关节面完全平整,关节面不同程度的台阶或塌陷,闭合复位外固定支架结合克氏针有限内固定组优良率分别为89.16％、89.28％及88.57％,而切开复位钢板螺钉内固定组优良率分别为90.27％、91.01％及88.89％.两组间差异无统计学意义(P＞0.05).结论 桡骨远端骨折手术目的在于恢复桡骨远端关节面的解剖形态,降低骨折畸形愈合率,外固定支架具有创伤小、操作简单等优点.即使关节面有1～2mm的台阶,会引起关节面负荷重分布,出现潜在创伤性关节炎的风险,但只要经过正确的功能康复,桡腕关节功能的恢复也可能较为理想.
目的 探討橈骨遠耑骨摺治療後橈腕關節形態學特徵與腕關節功能的相關性.方法 收集自2006年1月至2013年12月行閉閤複位外固定支架結閤剋氏針有限內固定及切開複位鋼闆螺釘內固定兩種方法治療的C型橈骨遠耑骨摺病例共388例,採用Dienst功能評分、X線片及CT片評價腕關節功能.結果 Dienst功能評分,恢複橈骨高度及恢複橈腕關節麵完全平整,關節麵不同程度的檯階或塌陷,閉閤複位外固定支架結閤剋氏針有限內固定組優良率分彆為89.16％、89.28％及88.57％,而切開複位鋼闆螺釘內固定組優良率分彆為90.27％、91.01％及88.89％.兩組間差異無統計學意義(P＞0.05).結論 橈骨遠耑骨摺手術目的在于恢複橈骨遠耑關節麵的解剖形態,降低骨摺畸形愈閤率,外固定支架具有創傷小、操作簡單等優點.即使關節麵有1～2mm的檯階,會引起關節麵負荷重分佈,齣現潛在創傷性關節炎的風險,但隻要經過正確的功能康複,橈腕關節功能的恢複也可能較為理想.
목적 탐토뇨골원단골절치료후뇨완관절형태학특정여완관절공능적상관성.방법 수집자2006년1월지2013년12월행폐합복위외고정지가결합극씨침유한내고정급절개복위강판라정내고정량충방법치료적C형뇨골원단골절병례공388례,채용Dienst공능평분、X선편급CT편평개완관절공능.결과 Dienst공능평분,회복뇨골고도급회복뇨완관절면완전평정,관절면불동정도적태계혹탑함,폐합복위외고정지가결합극씨침유한내고정조우량솔분별위89.16％、89.28％급88.57％,이절개복위강판라정내고정조우량솔분별위90.27％、91.01％급88.89％.량조간차이무통계학의의(P＞0.05).결론 뇨골원단골절수술목적재우회복뇨골원단관절면적해부형태,강저골절기형유합솔,외고정지가구유창상소、조작간단등우점.즉사관절면유1～2mm적태계,회인기관절면부하중분포,출현잠재창상성관절염적풍험,단지요경과정학적공능강복,뇨완관절공능적회복야가능교위이상.
Objective To investigate the correlation of radiocarpal joint morphological characteristics with wrist function after surgical treatment of distal radius fractures.Methods The data of 388 cases of type C distal radial fractures which were treated from January 2006 to December 2013 either by closed reduction and fixation with external fixator combined with limited Kirschner wire fixation,or by open reduction and internal fixation with plate and screws were analyzed.The wrist joint function was evaluated using Dienst functional score,X rays and CT scans.Results When treated with closed reduction and external fixator and K-wire fixation,the excellent outcome rate was 89.16％,89.28％ and 88.57％,respectively,based on Dienst functional score,recovery of radial height and radiocarpal joint surface congruity,and the degree of joint surface stepwise deformity or collapse.When treated with open reduction and internal fixation,the excellent rate was 90.27％,91.01％ and 88.89％,respectively.There were no significant differences between the two treatment groups (P ＞ 0.05).Conclusion The goal of surgical treatment of distal radius fractures is to restore the anatomy of the distal radius articular surface and decrease fracture malunion.External fixator fixation is a less invasive and simpler operation.Even if there is a potential risk of traumatic arthritis due to load redistribution caused by the 1 to 2 mm step in the joint surface,recovery of wrist function can be more desirable with proper functional rehabilitation.
