CAJ | 학술논문

背景：尺骨茎突骨折是桡骨远端骨折最常见的合并损伤，一直未引起临床医师的足够重视，骨折不愈合的发生率很高。目的：观察尺骨茎突骨折对桡骨远端骨折愈合及腕关节功能的影响。 　　方法：选择2011年1月至2012年12月急诊行手法整复及石膏固定治疗的桡骨远端骨折患者60例，均为AO分型A型，按照是否合并尺骨茎突骨折分为观察组和对照组，观察组30例，均合并尺骨茎突骨折；对照组30例，均不合并尺骨茎突骨折。治疗前两组的掌屈、背伸、桡偏、尺偏、旋前和旋后功能差异无统计学意义（P＞0.05）。比较两组治疗后6个月解剖学评分和功能评分的优良率，以及治疗前和治疗后6个月的腕关节功能。 　　结果：观察组治疗后6个月的解剖学评分和功能评分优良率分别为66.67%和70.00%，对照组为90.00%和93.33%，对照组的优良率明显高于观察组（P＜0.05）。两组治疗后6个月的掌屈、背伸、桡偏、尺偏、旋前和旋后功能均较治疗前明显提高（P＜0.01），对照组较观察组提高更为明显（P＜0.01）。 　　结论：尺骨茎突骨折对桡骨远端骨折的预后有一定影响，尤其对腕关节功能恢复影响较大，值得进一步研究。
배경：척골경돌골절시뇨골원단골절최상견적합병손상，일직미인기림상의사적족구중시，골절불유합적발생솔흔고。목적：관찰척골경돌골절대뇨골원단골절유합급완관절공능적영향。 　　방법：선택2011년1월지2012년12월급진행수법정복급석고고정치료적뇨골원단골절환자60례，균위AO분형A형，안조시부합병척골경돌골절분위관찰조화대조조，관찰조30례，균합병척골경돌골절；대조조30례，균불합병척골경돌골절。치료전량조적장굴、배신、뇨편、척편、선전화선후공능차이무통계학의의（P＞0.05）。비교량조치료후6개월해부학평분화공능평분적우량솔，이급치료전화치료후6개월적완관절공능。 　　결과：관찰조치료후6개월적해부학평분화공능평분우량솔분별위66.67%화70.00%，대조조위90.00%화93.33%，대조조적우량솔명현고우관찰조（P＜0.05）。량조치료후6개월적장굴、배신、뇨편、척편、선전화선후공능균교치료전명현제고（P＜0.01），대조조교관찰조제고경위명현（P＜0.01）。 　　결론：척골경돌골절대뇨골원단골절적예후유일정영향，우기대완관절공능회복영향교대，치득진일보연구。
Background:Ulnar styloid fracture is the most common combined injury of distal radius fracture. It has not gained enough attention of the clinicians, so the incidence of nonunion was very high. Objective:To observe the impacts of ulnar styloid fracture on the recovery of the distal radius fracture and wrist functions. Methods:Sixty patients with distal radius fracture of AO type A who received emergency treatment of manipulative reduc-tion and plaster fixation from January 2011 to December 2012 were divided into 2 groups, an observation group and a con-trol group, based on whether they had combined ulnar styloid fracture or not. The 30 cases in the observation group had combined injury of ulnar styloid fracture, while the 30 cases in the control group did not. There was no statistical signifi-cance between the 2 groups on the differences in the function of palmar flexion, dorsal extension, radial deviation, ulnar de-viation, pronation and supination before the treatment (P>0.05). The excellent-good rates of the anatomical scores and the functional scores of the 2 groups were compared 6 months after the treatment, and the wrist functions of the 2 groups were compared before and 6 months after the treatment. Results: Six months after the treatment, the excellent-good rates of the anatomical score and the functional score were 66.67%and 70.00%respectively in the observation group, and were 90.00%and 93.33%in the control group. The excellent-good rate of the control group was significantly higher than that of the observation group (P<0.05). Compared to the wrist functions before the treatment, the palmar flexion, dorsal extension, radial deviation, ulnar deviation, pronation and supina-tion functions of both groups were significantly improved 6 months after the treatment (P<0.01), and the improvement was more obvious in the control group (P<0.01). Conclusions:The ulnar styloid fracture can have some impacts on the prognosis of the distal radius fracture, especially on the recovery of the wrist functions. It is worth further study.