CAJ | 학술논문

目的：观察尺骨茎突骨折对桡骨远端骨折手术疗效及腕关节功能的影响。方法对64例不稳定桡骨远端骨折进行回顾性分析，选择AO分型为A型和B型的不稳定桡骨远端骨折患者，均行切开复位T型桡骨远端锁定钢板内固定治疗，尺骨茎突骨折未作特殊处理，将所有资料按照未合并尺骨茎突骨折组、尺骨茎突骨折（体部骨折）Ⅰ型组及尺骨茎突骨折（基底部骨折）Ⅱ型组分组进行整理分析，记录病例AO分型及术前、术后6个月和术后1年的X线片测量结果，按照Bunger提出的解剖学评分（掌倾角、尺偏角、桡骨茎突高度）进行解剖学评估，同时进行 Gartland-Werly评分。结果随访时间为7~12个月，平均11个月，64例桡骨远端骨折均愈合。未合并尺骨茎突骨折组、尺骨茎突骨折Ⅰ型组及Ⅱ型组术前、术后6个月及术后1年解剖学评分差异无统计学意义，未合并尺骨茎突骨折组与尺骨茎突骨折Ⅰ型组Gartlant-Werley评分、优良率差异无统计学意义。但未合并尺骨茎突骨折组与尺骨茎突骨折Ⅱ型Gartlant-Werley评分、优良率差异有统计学意义，尺骨茎突骨折Ⅰ型组与Ⅱ型组相比，Gartlant-Werley评分、优良率差异有统计学意义。结论尺骨茎突骨折与否及分型对桡骨远端骨折术后解剖学评分无影响，尺骨茎突体部骨折对腕关节功能无影响，但尺骨茎突基底部骨折对腕关节功能有一定影响，值得进一步研究。
목적：관찰척골경돌골절대뇨골원단골절수술료효급완관절공능적영향。방법대64례불은정뇨골원단골절진행회고성분석，선택AO분형위A형화B형적불은정뇨골원단골절환자，균행절개복위T형뇨골원단쇄정강판내고정치료，척골경돌골절미작특수처리，장소유자료안조미합병척골경돌골절조、척골경돌골절（체부골절）Ⅰ형조급척골경돌골절（기저부골절）Ⅱ형조분조진행정리분석，기록병례AO분형급술전、술후6개월화술후1년적X선편측량결과，안조Bunger제출적해부학평분（장경각、척편각、뇨골경돌고도）진행해부학평고，동시진행 Gartland-Werly평분。결과수방시간위7~12개월，평균11개월，64례뇨골원단골절균유합。미합병척골경돌골절조、척골경돌골절Ⅰ형조급Ⅱ형조술전、술후6개월급술후1년해부학평분차이무통계학의의，미합병척골경돌골절조여척골경돌골절Ⅰ형조Gartlant-Werley평분、우량솔차이무통계학의의。단미합병척골경돌골절조여척골경돌골절Ⅱ형Gartlant-Werley평분、우량솔차이유통계학의의，척골경돌골절Ⅰ형조여Ⅱ형조상비，Gartlant-Werley평분、우량솔차이유통계학의의。결론척골경돌골절여부급분형대뇨골원단골절술후해부학평분무영향，척골경돌체부골절대완관절공능무영향，단척골경돌기저부골절대완관절공능유일정영향，치득진일보연구。
Objective To observe the impact of ulnar styloid fracture on the healing and wrist function in patients with distal radius fracture. Methods From January 2010 to August 2012,64 cases with distal radius fractures were treated by ORIF,of which were followed-up with an average of 16 months(7~30 months). All ulnar styloid fractures were not fixed. Ac-cording to ulnar styloid fractures,all cases were divided into control group(23 cases without ulnar styloid fractures)and typeⅠ group( tip fracture of ulnar styloid,21 cases)and type Ⅱ group( base fracture of ulnar styloid,20 cases). Volar tilt,radial inclination and radial height were recorded before and after operation. Complications and Gartlant-Werley Scores were evaluated 6 months and 1 year after operation. Results All distal radial fractures were union in 8weeks to 12 weeks. There were no sig-nification differences in volar tilt,radial inclination and radial height. We found no signification differences in complications and Gartlant-Werley Scores between control group and type Ⅰ group,but signification differences between control group and typeⅡ group. There were signification differences between type Ⅰ group and type Ⅱ group. Conclusion The ulnar styloid base fracture has some influence on the prognosis of distal radius fracture,especially on the wrist function,it is worthy of further study.