CAJ | 학술논문

目的研究各型尺骨茎突骨折手术治疗与非手术治疗对桡尺远侧关节稳定性的影响.方法 2001年8月至2010年5月,对150例尺骨茎突骨折患者,其中Ⅰ型骨折68例、Ⅱ型骨折82例,通过术前影像学测量,术后随访桡尺远侧关节稳定性,对腕关节功能进行评定.结果通过腕关节标准侧位片,在豆舟骨间距≤3mm时,测量桡尺远侧关节间距,尺骨茎突骨折Ⅰ型桡尺远侧关节间距≤5mm,Ⅱ型≥5mm.术后随访时间为26～ 102个月,平均70个月.桡尺远侧关节稳定性:68例Ⅰ型骨折未出现桡尺远侧关节松弛,82例Ⅱ型骨折中11例出现桡尺远侧关节松弛.腕关节功能评定采用Green-O'Brien评分法:Ⅰ型骨折手术治疗28例,其中优12例、良11例,优良率为82.1％;非手术治疗40例,其中优10例、良19例,优良率为72.5％.Ⅱ型骨折手术治疗72例,其中优62例、良6例,优良率为94.4％;非手术治疗10例,其中优1例、良2例,优良率为30.0％.结论尺骨茎突骨折对桡尺远侧关节稳定性的影响,Ⅰ型较小,Ⅱ型较大.所以对Ⅱ型尺骨茎突骨折应采用手术治疗,使其解剖复位.
목적 연구각형척골경돌골절수술치료여비수술치료대뇨척원측관절은정성적영향.방법 2001년8월지2010년5월,대150례척골경돌골절환자,기중Ⅰ형골절68례、Ⅱ형골절82례,통과술전영상학측량,술후수방뇨척원측관절은정성,대완관절공능진행평정.결과 통과완관절표준측위편,재두주골간거≤3mm시,측량뇨척원측관절간거,척골경돌골절Ⅰ형뇨척원측관절간거≤5mm,Ⅱ형≥5mm.술후수방시간위26～ 102개월,평균70개월.뇨척원측관절은정성:68례Ⅰ형골절미출현뇨척원측관절송이,82례Ⅱ형골절중11례출현뇨척원측관절송이.완관절공능평정채용Green-O'Brien평분법:Ⅰ형골절수술치료28례,기중우12례、량11례,우량솔위82.1％;비수술치료40례,기중우10례、량19례,우량솔위72.5％.Ⅱ형골절수술치료72례,기중우62례、량6례,우량솔위94.4％;비수술치료10례,기중우1례、량2례,우량솔위30.0％.결론 척골경돌골절대뇨척원측관절은정성적영향,Ⅰ형교소,Ⅱ형교대.소이대Ⅱ형척골경돌골절응채용수술치료,사기해부복위.
Objective To investigate the impact on distal radioulnar joint(DRUJ) stability by various types of ulnar styloid fractures surgically and non-surgically treated.Methods A total of 150 cases of ulnar styloid fractures treated between August 2001 and May 2010 were involved in this study.There were 68 cases of type Ⅰ fractures and 82 cases of type Ⅱ fractures.Preoperative radiographic measurements,postoperative evaluation of DRUJ stability and wrist function were carried out.Results Preoperatively spacing of the DRUJ was measured on standard lateral wrist Ⅹ-Rays when the distance from the pisiform to the scaphoid was less than 3 mm.The spacing was less than 5 mm in type Ⅰ fractures and more than 5 mm in type Ⅱ fractures.All the patients were follow-up for 26 to 102 months,with an average of 70 months.There was no relaxation of the DRUJ among 68 type Ⅰ cases,whereas DRUJ relaxation occurred in 11 of the 82 type Ⅱ cases.Evaluation of wrist function using Green-O'Brien evaluation criteria revealed excellent results in 12 and good results in 11 of the 28 type Ⅰ ulnar styloid fracture cases treated surgically.The overall satisfactory rate of this cohort was 82.1％.Of the 40 non-surgically treated type Ⅰ cases,results were rated as excellent in 10 cases and good in 19 cases,with an overall satisfactory rate of 72.5 ％.72 of type Ⅱ ulnar styloid fractures were surgically treated leading to excellent results in 62 cases and good results in 6 cases,with a 94.4％ satisfactory rate.Non-surgical treatment of the other 10 type Ⅱ cases led to excellent results in 1 case and good results in 2 cases,achieving a 30.0％ satisfactory rate.Conclusion Type Ⅰ ulnar styloid fractures have less impact on DRUJ stability than type Ⅱ fractures.Type Ⅱ ulnar styloid fractures therefore should be surgically treated to achieve anatomical reduction and preserve DRUJ stability.